Abstract
SARS-CoV-2 pandemic and COVID-19 diffusion have recently become an international public health emergency. Cancer patients, as a frail population, are particularly exposed to the risk related to infections. The clinical decision-making process and the organizational workflow of radiotherapy department should be revised in the light of the critical situation. We herein provide practical suggestions derived from the available literature and discussed during an online session held within the e-learning educational program of the European School of Oncology on March 31st 2020.
Highlights
At the end of December 2019, in the city of Wuhan Hubei Province, China, the observation of a cluster of patients with severe respiratory syndrome lead to discovery of the SARS-CoV-2 infection, which is presently known to be responsible for COVID-19 [1]
By mid-February, more than 60.000 cases were reported in China, and by midMarch, around 170.000 cases were observed worldwide, prompting the World Health Organization (WHO) to label the coronavirus outbreak as a pandemic on March 11th, 2020 [2]
Breast cancer is a paradigmatic example on how the radiotherapy decision-making process can be adapted to this particular situation and a proof of the versatility of radiation oncology treatment strategies, as pointed out in the guidelines for breast cancer during the COVID-19 pandemic [13]
Summary
At the end of December 2019, in the city of Wuhan Hubei Province, China, the observation of a cluster of patients with severe respiratory syndrome lead to discovery of the SARS-CoV-2 infection, which is presently known to be responsible for COVID-19 [1]. Data from Wuhan highlighted a case fatality rate for cancer patients up to 5.6% compared to 2.1% of the general population They bear a 5-fold relative risk of severe respiratory manifestations, requiring invasive ventilation and leading to death [5, 6]. Radiotherapy would be considered as a “life-saving” procedure, and efforts should be placed to ensure its access to all cancer patients [8] In such a critical situation, as the COVID-19 pandemic is, and given the fractionated nature of radiotherapy treatments, the risk-benefit ratio may be different and specific decisions and actions could be taken, in case of concurrent chemotherapy administration, calling for shared and interdisciplinary decision-making [9]. We would like to wrap up the main findings, inspired by the online session that was held on March 31st, 2020, within the European School of Oncology online education platform e-ESO (http://www.eso.net)
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