1
|
Tibdewal A, Pathak R, Kumar A, Anand S, Ghosh Laskar S, Sarin R, Chopra S, Engineer R, Laskar S, Murthy V, Gupta T, Agarwal JP. Impact of the First Wave of COVID-19 Pandemic on Radiotherapy Practice at Tata Memorial Centre, Mumbai: A Longitudinal Cohort Study. JCO Glob Oncol 2022; 8:e2100365. [PMID: 35802835 PMCID: PMC9296187 DOI: 10.1200/go.21.00365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 04/15/2022] [Accepted: 06/03/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Delivery of cancer care during the pandemic required adopting various changes in the standard management. We analyzed the impact of the first wave of the COVID-19 pandemic on radiation oncology treatment practices at Tata Memorial Hospital in India. MATERIALS AND METHODS From March 1 to October 31, 2020, all consecutive patients who attended the radiation oncology department for radiotherapy treatment were included in this study. Electronic medical records, patient files, and telephonic consult were used to collect patient's data including changes in the standard treatment practice, COVID-19 testing and its results, and subsequent impact on radiotherapy treatment. Comparison was done with the same period data of 2019 for the number of the caseload, radiotherapy regimen, referral rates, and noncompliance rates. RESULTS Our study included 4,256 patients with a median age of 52 years (interquartile range 41-61 years). There was a significant drop in the new-patient registrations (approximately 63%), radiotherapy consultations (44.9%), and referrals to other centers (27.8%). The reduction in the caseload was highest for genitourinary cases (-58.5%) and the lowest for breast cases (-11.5%) when compared with the 2019 cohort. Among those treated with radical intent, the noncompliance rate was 15%. Hypofractionation was the commonly adopted regimen across all sites. Compared with 2019, the maximum reduction in the average fractions per patient was seen in the breast cancer cases (-8.2 fraction), followed by genitourinary cases (-4.9 fraction). Of the 27.8% of patients tested for COVID-19, 13.4% turned positive and 3.4% died due to the disease. CONCLUSION The COVID-19 pandemic adversely affected the number of radiotherapy consultations and treatments at our institute. However, our department offered uninterrupted services despite grave challenges. Hypofractionated regimen was used across disease sites to minimize patient visits and allow planned treatment completion. Radiotherapy was delivered safely, and patients experienced low rates of COVID positivity during radiotherapy and even lower mortality.
Collapse
Affiliation(s)
- Anil Tibdewal
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rima Pathak
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Anuj Kumar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sachith Anand
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sarbani Ghosh Laskar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rajiv Sarin
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Supriya Chopra
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Reena Engineer
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Siddharth Laskar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vedang Murthy
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Tejpal Gupta
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Jai Prakash Agarwal
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| |
Collapse
|
2
|
Venkatasai J, John C, Kondavetti SS, Appasamy M, Parasuraman L, Ambalathandi R, Masilamani H. Impact of COVID-19 Pandemic on Patterns of Care and Outcome of Head and Neck Cancer: Real-World Experience From a Tertiary Care Cancer Center in India. JCO Glob Oncol 2022; 8:e2100339. [PMID: 35213235 PMCID: PMC8887950 DOI: 10.1200/go.21.00339] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 pandemic has caused unprecedented health, social, and economic unrest globally, particularly affecting resource-limited low-middle–income countries. The resultant curfew had made the access to and delivery of cancer care services an arduous task. We have reported the patterns of care and 1-year outcome of head and neck squamous cell carcinoma (HNSCC) treatment before and during COVID-19 lockdown at our institution. COVID-19 restrictions can have adverse impact on the access to and delivery of RT #HNCSM #COVID19![]()
Collapse
Affiliation(s)
- Jeyaanth Venkatasai
- Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Christopher John
- Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Satish Srinivas Kondavetti
- Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Mallika Appasamy
- Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | | | - Ravichandran Ambalathandi
- Department of Medical Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Hemavathi Masilamani
- Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| |
Collapse
|
3
|
Fagan JJ, Noronha V, Graboyes EM. Making the Best of Limited Resources: Improving Outcomes in Head and Neck Cancer. Am Soc Clin Oncol Educ Book 2021; 41:1-11. [PMID: 33793315 PMCID: PMC8059263 DOI: 10.1200/edbk_320923] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The overwhelming majority of head and neck cancers and related deaths occur in low- and middle-income countries, which have challenges related to burden of disease versus access to care. Yet the additional health care burden of the COVID-19 pandemic has also impacted access to care for patients with head and neck cancer in the United States. This article focuses on challenges and innovation in prioritizing head and neck cancer care in Sub-Saharan Africa, the Indian experience of value-added head and neck cancer care in busy and densely populated regions, and strategies to optimize the management of head and neck cancer in the United States during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Johannes J. Fagan
- Division of Otorhinolaryngology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - Evan Michael Graboyes
- Departments of Otolaryngology-Head and Neck Surgery and Public Health Sciences, Medical University of South Carolina, Charleston, SC
| |
Collapse
|