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Matuschek C, Fischer JC, Combs SE, Fietkau R, Corradini S, Zänker K, Bölke E, Djiepmo-Njanang FJ, Tamaskovics B, Fischer JE, Stuschke M, Pöttgen C, Förster R, Zwahlen DR, Papachristofilou A, Ganswindt U, Pelka R, Schneider EM, Feldt T, Jensen BEO, Häussinger D, Knoefel WT, Kindgen-Milles D, Pedoto A, Grebe O, van Griensven M, Budach W, Haussmann J. Measures of infection prevention and incidence of SARS-CoV-2 infections in cancer patients undergoing radiotherapy in Germany, Austria and Switzerland. Strahlenther Onkol 2020; 196:1068-1079. [PMID: 32914236 PMCID: PMC7483062 DOI: 10.1007/s00066-020-01681-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023]
Abstract
Purpose COVID-19 infection has manifested as a major threat to both patients and healthcare providers around the world. Radiation oncology institutions (ROI) deliver a major component of cancer treatment, with protocols that might span over several weeks, with the result of increasing susceptibility to COVID-19 infection and presenting with a more severe clinical course when compared with the general population. The aim of this manuscript is to investigate the impact of ROI protocols and performance on daily practice in the high-risk cancer patients during this pandemic. Methods We addressed the incidence of positive COVID-19 cases in both patients and health care workers (HCW), in addition to the protective measures adopted in ROIs in Germany, Austria and Switzerland using a specific questionnaire. Results The results of the questionnaire showed that a noteworthy number of ROIs were able to complete treatment in SARS-CoV‑2 positive cancer patients, with only a short interruption. The ROIs reported a significant decrease in patient volume that was not impacted by the circumambient disease incidence, the type of ROI or the occurrence of positive cases. Of the ROIs 16.5% also reported infected HCWs. About half of the ROIs (50.5%) adopted a screening program for patients whereas only 23.3% also screened their HCWs. The range of protective measures included the creation of working groups, instituting home office work and protection with face masks. Regarding the therapeutic options offered, curative procedures were performed with either unchanged or moderately decreased schedules, whereas palliative or benign radiotherapy procedures were more often shortened. Most ROIs postponed or cancelled radiation treatment for benign indications (88.1%). The occurrence of SARS-CoV‑2 infections did not affect the treatment options for curative procedures. Non-university-based ROIs seemed to be more willing to change their treatment options for curative and palliative cases than university-based ROIs. Conclusion Most ROIs reported a deep impact of SARS-CoV‑2 infections on their work routine. Modification and prioritization of treatment regimens and the application of protective measures preserved a well-functioning radiation oncology service and patient care. Electronic supplementary material The online version of this article (10.1007/s00066-020-01681-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christiane Matuschek
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Duesseldorf, Germany
| | - Johannes C Fischer
- Institute for Transplant Diagnostics and Cell Therapeutics, Heinrich Heine University, Düsseldorf, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Technical University of Munich, Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum Munich, Munich, Germany.,Partner Site Munich, Deutsches Konsortium für Translationale Krebsforschung (DKTK), Munich, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, University of Erlangen, Erlangen, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | | | - Edwin Bölke
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Duesseldorf, Germany.
| | | | - Balint Tamaskovics
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Duesseldorf, Germany
| | | | - Martin Stuschke
- Department of Radiation Oncology, University Essen, Essen, Germany
| | | | - Robert Förster
- Institute of Radiation Oncology, Cantonal Hospital Winterthur, University of Zurich, Zurich, Switzerland
| | - Daniel R Zwahlen
- Institute of Radiation Oncology, Cantonal Hospital Winterthur, University of Zurich, Zurich, Switzerland
| | | | - Ute Ganswindt
- Department of Radiation Oncology, Medical University Innsbruck, Innsbruck, Austria
| | - Rainer Pelka
- Institute for Applied Statistics, Unterföhring/Munich, Germany
| | - E Marion Schneider
- Division of Experimental Anesthesiology, University Hospital Ulm, Ulm, Germany
| | - Torsten Feldt
- Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University, Duesseldorf, Germany
| | - Björn Erik Ole Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University, Duesseldorf, Germany
| | - Dieter Häussinger
- Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University, Duesseldorf, Germany
| | - Wolfram Trudo Knoefel
- Department for General Visceral and Pediatric Surgery, Heinrich Heine University, Dusseldorf, Germany
| | - Detlef Kindgen-Milles
- Department of Intensive Care Medicine, Heinrich Heine University, Dusseldorf, Germany
| | - Alessia Pedoto
- Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Olaf Grebe
- Department for Cardiology, Rhythmology and Intensive Care Medicine, Evangelic Hospital, Dusseldorf, Germany
| | - Martijn van Griensven
- MERLN Institute for Technology-Inspired Regenerative Medicine, Department cBITE, Maastricht University, Maastricht, The Netherlands
| | - Wilfried Budach
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Duesseldorf, Germany
| | - Jan Haussmann
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Duesseldorf, Germany
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