A national survey on radiation oncology patterns of practice in Switzerland during the COVID-19 pandemic: Present changes and future perspectives

Achard, Vérane; Aebersold, Daniel M.; Allal, Abdelkarim Said; Andratschke, Nicolaus; Baumert, Brigitta G.; Beer, Karl; Betz, Michael; Breuneval, T.; Bodis, Stephan; Bari, Berardino De; Forster, R. E.; Franzetti-Pellanda, Alessandra; Gückenberger, Matthias; Herrmann, Evelyn; Huck, Constance; Khanfir, K.; Matzinger, Oscar; Péguret, Nicolas; Pesce, G.; Putora, Paul Martin; Reuter, Christiane; Richetti, A.; Vees, Hansjörg; Vrieling, Conny; Zaugg, Kathrin; Zimmermann, Frank; Zwahlen, Daniel R.; Tsoutsou, Pelagia G.; Zilli, Thomas

doi:10.1016/j.radonc.2020.05.047

Cited by 26 publications

(41 citation statements)

References 10 publications

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“…Similar to our experience, the Swiss survey reported an increase of hypofractionation, even though with a lower percentage compared to ours (5-18% and 25.6-42.1%, respectively) [29]. It will be interesting to see whether ROIs will continue using the shorter treatment protocols, especially for curative treatments of breast or prostate cancers.…”

Section: Discussionsupporting

confidence: 84%

Measures of infection prevention and incidence of SARS-CoV-2 infections in cancer patients undergoing radiotherapy in Germany, Austria and Switzerland

et al. 2020

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Purpose COVID-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. Methods We 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. Results The 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. Conclusion Most 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.

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Section: Discussionsupporting

confidence: 84%

Measures of infection prevention and incidence of SARS-CoV-2 infections in cancer patients undergoing radiotherapy in Germany, Austria and Switzerland

et al. 2020

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“…Most publications measuring the impact of COVID-19 on RTD are based on a single questionnaire ( 8 , 13 , 14 , 18 , 19 ). Our survey, which took place over several weeks, allows for the evaluation of the impact of the pandemic on RTH treatment over time and as such illustrates the dynamic nature of how COVID-19 impacted treatment activity.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Patients and Staff in Radiation Oncology Departments in Belgium: A National Survey

et al. 2021

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Purpose: COVID-19 reached Belgium in February and quickly became a major public health challenge. It is of importance to evaluate the actual impact of COVID-19 on patients and staff in Belgian radiotherapy departments (RTDs). This was evaluated through a weekly national survey sent to departments measuring key factors that were affected by the pandemic.Materials and Methods: The Belgian SocieTy for Radiation Oncology (BeSTRO) together with the Belgian College for physicians in Radiation Oncology invited all 26 RTD to participate in a survey that started on March 2nd and was re- submitted weekly for 4 months to assess variations in time. The survey focused on: (1) the COVID-19 status of patients and staff; (2) the management of clinically suspected COVID patients and COVID positive patients; (3) the impact of COVID-19 on RTD activities; (4) its impact in radiotherapy indications and fractionation schemes.Results: Seventy-three percent of 26 RTDs completed the first survey and 57% responded to all weekly surveys. In the RTD staff, 24 members were COVID-positive of whom 67% were RTTs. Over the study period, the number of patients treated dropped by a maximum of 18.8% when compared to March 2nd. In 32.3% of COVID-positive and 54% of COVID suspected patients, treatment was continued without any interruptions. Radiotherapy indications were adapted within the 1st weeks of the survey in 47.4% of RTD, especially for urological and breast tumors. Fractionation schemes were changed in 68.4% of RTD, mainly for urological, breast, gastro-intestinal, and lung tumors.Conclusions: Between March and June 2020, the COVID-19 pandemic resulted in an important decrease in treatment activity in RTD in Belgium (18.8%). The COVID-19 infection status of patients influenced the continuity of the radiotherapy schedule. Changes in indications and fractionation schedules of radiotherapy were rapidly incorporated in the different RTD.

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“…Presently, HFRT has been successfully used in a wide range of disease sites and with similar efficacy without any significant acute or late morbidities, and hence it has been recommended during the COVID-19 pandemic resource constraints. [28][29][30][31][32][33][34][35] The HFRT dosefractionation schedules could be further adapted depending on the clinical situation, as has been recently jointly proposed for head and neck cancers by the American Society for Radiation Oncology-European Society for Radiotherapy and Oncology. 36 The BEDs for early and late effects of the mild to moderate HFRT regimes evaluated in the present study are marginally higher than those of SFRT at 2 Gy/fraction and therefore could be safely implemented in routine clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Strategies to Maximize Available Resources With Minimum Cost Escalation for Improving Radiation Therapy Accessibility in the Post–Coronavirus Disease 2019 Era: An Analysis for Asia

Datta

Samiei

2021

Advances in Radiation Oncology

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Purpose There is widespread accord among economists that the COVID-19 pandemic will have a severe negative impact on the global economy. Establishing new radiotherapy (RT) infrastructure may be significantly compromised in the post COVID-19 era. Alternative strategies are needed to improve the existing RT accessibility without significant cost escalation. The outcomes of these approaches on the RT availability has been examined for Asia. Methods and Materials The details of RT infrastructures in 2020 for 51 countries in Asia were obtained from the Directory of Radiotherapy Centers of the International Atomic Energy Agency (IAEA). Using the IAEA guidelines, the %RT accessibility and the additional requirements of teletherapy (TRT) units were computed for these countries. To maximize the utilization of the existing RT facilities, five options were evaluated, namely, hypofractionation RT (HFRT) alone, with/without 25% or 50% additional working hours. The impact of these strategies on the %RT access and additional TRT unit requirements to achieve 100% RT access were estimated. Results 4617 TRT units are available in 46 countries. The mean %RT accessibility is 62.4% in 43 countries (TRT units =4491) where the information on cancer incidence was also available and these would need an additional 6474 TRT units for achieving 100% RT accessibility. By adopting HFRT alone, increasing the working hours by 25% alone, 25% with HFRT, 50% alone and 50% with HFRT; the %RT access could improve to 74.9%, 78%, 90.5%, 93.7% and 106.1% respectively. Correspondingly, the need for additional TRT units would progressively decrease to 4646, 4284, 3073, 2820 and 1958 units. Conclusion The economic slowdown in the post Covid-19 period could severely impend establishment of new RT facilities. Thus, maximal utilization of the available RT infrastructure with minimum additional costs could be possible by adopting HFRT with or without increased working hours to improve the RT coverage.

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A national survey on radiation oncology patterns of practice in Switzerland during the COVID-19 pandemic: Present changes and future perspectives

Cited by 26 publications

References 10 publications

Measures of infection prevention and incidence of SARS-CoV-2 infections in cancer patients undergoing radiotherapy in Germany, Austria and Switzerland

Measures of infection prevention and incidence of SARS-CoV-2 infections in cancer patients undergoing radiotherapy in Germany, Austria and Switzerland

Impact of the COVID-19 Pandemic on Patients and Staff in Radiation Oncology Departments in Belgium: A National Survey

Strategies to Maximize Available Resources With Minimum Cost Escalation for Improving Radiation Therapy Accessibility in the Post–Coronavirus Disease 2019 Era: An Analysis for Asia

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