Abstract
BackgroundIt remains unknown how the COVID-19 pandemic has changed neuro-oncology clinical practice, training, and research efforts.MethodsWe performed an international survey of practitioners, scientists, and trainees from 21 neuro-oncology organizations across 6 continents, April 24–May 17, 2020. We assessed clinical practice and research environments, institutional preparedness and support, and perceived impact on patients.ResultsOf 582 respondents, 258 (45%) were US-based and 314 (55%) international. Ninety-four percent of participants reported changes in their clinical practice. Ninety-five percent of respondents converted at least some practice to telemedicine. Ten percent of practitioners felt the need to see patients in person, specifically because of billing concerns and pressure from their institutions. Sixty-seven percent of practitioners suspended enrollment for at least one clinical trial, including 62% suspending phase III trial enrollments. More than 50% believed neuro-oncology patients were at increased risk for COVID-19. Seventy-one percent of clinicians feared for their own personal safety or that of their families, specifically because of their clinical duties; 20% had inadequate personal protective equipment. While 69% reported increased stress, 44% received no psychosocial support from their institutions. Thirty-seven percent had salary reductions and 63% of researchers temporarily closed their laboratories. However, the pandemic created positive changes in perceived patient satisfaction, communication quality, and technology use to deliver care and mediate interactions with other practitioners.ConclusionsThe pandemic has changed treatment schedules and limited investigational treatment options. Institutional lack of support created clinician and researcher anxiety. Communication with patients was satisfactory. We make recommendations to guide clinical and scientific infrastructure moving forward and address the personal challenges of providers and researchers.
Highlights
The COVID-19 pandemic has created many challenges for healthcare[1]
No consensus exists about risks for SARS-CoV-2 infection in neuro-oncology patients
Neuro-oncology, which focuses on treating patients with primary and metastatic brain and central nervous system (CNS) tumors and neurologic complications of cancer, has faced challenges, in maintaining quality patient care and conducting clinical trials and laboratory research
Summary
The pandemic has changed treatment schedules and limited investigational treatment options. Rip Keywords Accepted Manusc COVID-19, neuro-oncology outcomes, clinical trial enrollment. Clinical trial suspension, including phase III trials was a hallmark of the pandemic. 2. Practitioners and researchers perceive significant personal risk in doing their jobs. 3. No consensus exists about risks for SARS-CoV-2 infection in neuro-oncology patients. T Importance of the Study ip This is the first international study of the impact of the COVID-19 pandemic on the field of r neuro-oncology. We observed changes in treatment options for patients with brain and spine c tumors, as well as burdens on clinicians and researchers. We highlight major challenges in the s field, including suspension of clinical trials; financial pressures for practitioners to see patients in u person; and unmet safety concerns and high anxiety of practitioners and scientists. This work serves as a benchmark Accepted M assessment of the field during the early days of the pandemic
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