COVID-19: hypofractionation in the Radiation Oncology Department during the 'state of alarm': first 100 patients in a private hospital in Spain.

Luis Larrea,Miguel Ángel Berenguer,Maria Carmen Baños,Verónica González,Enrique López,Jose Bea,Paola Antonini,Jose Domingo

doi:10.3332/ecancer.2020.1052

Abstract

During the COVID-19 pandemic, Spain declared a ‘state of alarm’ on 14 March 2020. In our Radiation Oncology Department, experienced in administering hypofractionated treatments (partial irradiation in breast cancer, moderate hypofractionation in localized prostate cancer, etc), we have increased the hypofractionated treatment indications. We are only deferring the start of non-urgent treatments such as prostate tumours under androgen deprivation or benign brain tumours which are candidates for radiosurgery such as meningiomas or acoustic neuroma.In this hypofractionation era we find that we have decreased the number of sessions per patient and that we can evaluate the last years with the fractionation index (FI) (calculated by dividing the total number of fractions administered in the department by the total number of patients treated). We have gone from 14.4 in 2018 to 13.78 in 2019, excluding brachytherapy.We report the results of the first 100 patients who have experienced radiotherapy treatment since the state of alarm (66 women and 34 men). In these patients, the FI is 12.12—lower than previous years.

Highlights

In Spain, on 14 March 2020, a ‘state of alarm’ was declared due to the COVID-19 pandemic, forcing citizens to be confined at home with movement restrictions
At the Radiation Oncology Department, we established major indication of hypofractionated treatments in the majority of new patients attended, according to the recommendations of national and international societies. In those patients where it was possible, we delayed some treatments until the end of the maximum contagion period, for example, prostate cancer under androgen deprivation (AD) therapy or with low-grade staging, as well as radiosurgery for benign brain tumours, such as meningioma or acoustic neuroma
We included all patients treated with external beam radiation therapy, excluding brachytherapy procedures

Summary

Introduction

In Spain, on 14 March 2020, a ‘state of alarm’ was declared due to the COVID-19 pandemic, forcing citizens to be confined at home with movement restrictions. At the Radiation Oncology Department, we established major indication of hypofractionated treatments in the majority of new patients attended, according to the recommendations of national and international societies. In those patients where it was possible, we delayed some treatments until the end of the maximum contagion period, for example, prostate cancer under androgen deprivation (AD) therapy or with low-grade staging, as well as radiosurgery for benign brain tumours, such as meningioma or acoustic neuroma. Our experience is to treat an average of 800–1200 patients per year

Materials and methods

Results

Conclusion