Abstract
PurposeCOVID-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.MethodsWe 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.ResultsThe 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.ConclusionMost 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.
Highlights
The coronavirus disease 2019 (COVID-19) outbreak has become one of the greatest challenges for modern societies, economies and medicine
This work aims to quantify the incidence of COVID-19 in these departments, to measure and analyze the countermeasures taken by Radiation oncology institutions (ROI) to decrease the risk of infection for both patients and healthcare workers (HCW), and to evaluate changes in treatment policy during the pandemic
Additional invitations were sent on 5–7 May 2020 to all registered ROIs of the Swiss Society for Radiation Oncology (SRO, SSRO) (n = 37)
Summary
The coronavirus disease 2019 (COVID-19) outbreak has become one of the greatest challenges for modern societies, economies and medicine. Most countries in the world have been affected by this pandemic viral infection [1,2,3,4,5,6,7]. The SARS-CoV-2 infection poses a significant threat to cancer patients as they can be more susceptible to the pathogenic complications associated with the infection compared to the general population [2]. Patients with malignant tumors are generally older and affected by additional comorbidities [8]. Oncological treatments including chemotherapy, radiotherapy and the use of additional systemic agents might be associated with lymphopenia and result in an impaired immune response to viral infections [9]. Cancer fever and other nonspecific symptoms may mask the signs of early COVID19 infections
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