Impact of the COVID-19 Pandemic Lockdown on Radiotherapy Patients: A Retrospective Cohort Study

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to the imposition of a strict nationwide lockdown, which has affected all aspects of healthcare, including the delivery of standard care to cancer patients. Objective: The aim of this study was to report the impact of the COVID-19 pandemic on patient attendance at a radiotherapy department during the lockdown period. Methods: This is a retrospective analysis of all patients planned for radiotherapy at the National Institute of Oncology in Rabat. Patient compliance to radiotherapy during the lockdown period was measured and compared with that during the same period in 2019. Data regarding age, sex, tumor site and treatment-related factors were analyzed and compared with those during the same period in 2019. Results: We included a total of 650 patients, 348 patients in Group A (control period) and 302 in Group B (lockdown period). Patients were aged between 30 and 70 years in about 85%, with a female predominance in both groups. The most common sites of occurrence of cancer were breast, female reproductive organs and the head and neck. A 13.2% reduction in the number of treated patients and a 16.9% reduction in the number of sessions was observed. There was a significant decrease in the proportion of breast cancers treated (P = 0.03). The proportion of patients receiving palliative radiotherapy increased significantly (P = 0.03), with a significant increase in the use of single-fraction palliative radiation therapy (P = 0.006). There was a significant difference in the compliance to radiotherapy during the lockdown period (92.3% versus 86.4%, P = 0.01); delays and interruptions were due to travel restrictions (58.5%) and fear of contamination (29.2%). No patient was tested positive for COVID-19 during radiotherapy during the study period. Conclusion: We observed a decrease in the number of treated patients during the lockdown despite our efforts to maintain the treatment routine. A significant decrease in radiotherapy compliance was noted during the lockdown. The proportion of irradiated breast cancers decreased significantly during the lockdown while patients treated with palliative intent increased significantly, with increased use of single-fraction palliative radiotherapy.