Abstract
Aim: To assess the tendencies of radiation oncologists (ROs) in adjusting radiotherapy treatments (RTH) according to the coronavirus disease 2019 (COVID-19) status of patients during the early severe acute respiratory syndrome coronavirus 2 (SARS-COV2) pandemic in Europe.Material and methods: An electronic survey was sent to 79 academic RTH departments across Europe. Only one respondent per institution was included. Respondents were asked how they would adjust RTH treatments based on COVID-19 status for more common cancers during the first wave of the pandemic. Respondents were also asked to report the number of external beam radiotherapy (EBRT) units and the number of new cases referred to their department. Descriptive statistical analysis was conducted focusing on different cancers.Results: The overall response rate to the survey was 30.38% (24 institutions from 13 European countries). There was a wide range of different institutions regarding the number of patients, radiation oncologists, and facilities. A large proportion of respondents supported adjustment of RTH treatment (delay or switch to a shorter fractionation) for COVID-19-negative patients during the first wave of the pandemic only for early breast cancer (20% delay, 42.3% shorter), prostate cancer (53.6% delay, 21.4% shorter), and benign brain tumours (32% delay, 12% shorter). For COVID-19-negative patients with other cancers, most respondents recommended the standard RTH treatment. For COVID-19-positive patients, most respondents favoured a delay in RTH treatment or a shorter fractionation, regardless of cancer type and stage.Conclusion: The patient's COVID status significantly influenced the decision to undergo RTH treatment, regardless of the type and aggressiveness of cancer.
Highlights
The outbreak of coronavirus disease 2019 (COVID-19) in 2020 had a significant impact on cancer care management
A large proportion of respondents supported adjustment of radiotherapy treatments (RTH) treatment for COVID-19-negative patients during the first wave of the pandemic only for early breast cancer (20% delay, 42.3% shorter), prostate cancer (53.6% delay, 21.4% shorter), and benign brain tumours (32% delay, 12% shorter)
For COVID-19-positive patients, most respondents favoured a delay in RTH treatment or a shorter fractionation, regardless of cancer type and stage
Summary
The outbreak of coronavirus disease 2019 (COVID-19) in 2020 had a significant impact on cancer care management. Cancer patients are most vulnerable due to frequent contact with medical staff during treatment. Cancer itself, current or previous treatments, and the age of cancer patients make them more likely to suffer from infectious diseases due to their weakened immune status [1,2]. Original articles, case reports, and editorials have been published during the pandemic addressing these issues in a broad or specific disease area or for a particular treatment modality [5-15]. Recommendations to adapt RTH treatment according to the COVID-19 status of patients were only provided for head and neck tumours [13]. No recommendations were made to adjust RTH treatments for other cancer types depending on the patient's COVID status
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