COVID-19 Outbreak and Cancer Radiotherapy Disruption in Lombardy, Northern Italy

Jereczek‐Fossa, Barbara Alicja; Palazzi, Mauro; Soatti, Carlo Pietro; Cazzaniga, L.F.; Ivaldi, Giovanni Battista; Pepa, Matteo; Amadori, Marcello; Antognoni, Paolo; Arcangeli, Stefano; Buffoli, Alberto; Beltramo, G.; Berlinghieri, S.; Bignardi, Mario; Bracelli, Stefano; Bruschieri, Lorenza; Castiglioni, S.; Catalano, Gianpiero; Muzio, N. Di; Fallai, C.; Fariselli, Laura; Filippi, Andrea Riccardo; Gramaglia, Alberto; Italia, C.; Lombardi, Fabrizio; Magrini, Stefano Maria; Nava, Simonetta; Orlandi, Ester; Pasinetti, Nadia; Sbicego, Elena Lara; Scandolaro, Luciano; Scorsetti, Marta; Stiglich, F; Tonoli, Sandro; Tortini, Roberto; Valdagni, Riccardo; Vavassori, V.; Marvaso, Giulia

doi:10.1016/j.clon.2020.04.007

Cited by 28 publications

(43 citation statements)

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“…This particular situation carried a double risk due to the potential of delays or interruptions in to oncological therapies, which, despite being a "lifesaving" treatment, could have been hazardous to patients who are often already frail and also at high risk of infection themselves as well as to carers and health personnel alike. Several scientific documents and papers published on the subject represented an important reference point especially in the first phase of the emergency [11][12][13][14][15][16][17] and with particular regard to the use of protection systems, triage procedures and the use of hypofractionation schemes. In particular, a national survey conducted by the Italian Society of Radiotherapy and Clinical Oncology and, prior even to this, a survey of the radiotherapy centers of the Lombardy region, the region most affected by COVID-19 [10,14], both reported and supported the measures, implemented for the new rearrangement of centers, the workloads necessary and the COVID-19 cases found.…”

Section: Discussionmentioning

confidence: 99%

“…Several scientific documents and papers published on the subject represented an important reference point especially in the first phase of the emergency [11][12][13][14][15][16][17] and with particular regard to the use of protection systems, triage procedures and the use of hypofractionation schemes. In particular, a national survey conducted by the Italian Society of Radiotherapy and Clinical Oncology and, prior even to this, a survey of the radiotherapy centers of the Lombardy region, the region most affected by COVID-19 [10,14], both reported and supported the measures, implemented for the new rearrangement of centers, the workloads necessary and the COVID-19 cases found. Most of the measures adopted and reported in the surveys are in line with the planned approach undertaken in our particular experience with the exception of the "working from home scheme" which cannot Triage area with nursing staff: (a) entry for 4 patients at a time with a distance of at least 1 m; (b) body temperature detection with Thermo can; (c) finding of respiratory symptoms, ocular disorders (conjunctivitis), dysgeusia and anosmia; (d) contacts with suspected COVID-19 by filling of the dedicated Hospital questionnaire; (e) obligation of surgical mask for patients and carers [18][19][20][21] As per Phase I…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the Italian Association of Radiotherapy and Clinical Oncology (AIRO) implemented a document to make radiotherapy operating procedures homogeneous throughout the ongoing COVID-19 emergency [9] and conducted a targeted national survey [10]. To this regard, several experiences have been published on the management of radiation therapy during the pandemic [11][12][13][14][15][16][17]. We aim to report here our particular experience in the organizational planning of radiotherapy during the two phases of the COVID-19 emergency, lockdown phase I and postlockdown phase II.…”

Section: Open Accessmentioning

confidence: 99%

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COVID-19 and radiation oncology: the experience of a two-phase plan within a single institution in central Italy

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Background COVID-19 in Italy has led to the need to reorganize hospital protocols with a significant risk of interruption to cancer treatment programs. In this report, we will focus on a management model covering the two phases of the COVID-19 emergency, namely lockdown-phase I and post-lockdown-phase II. Methods The following steps were taken in the two phases: workload during visits and radiotherapy planning, use of dedicated routes, measures for triage areas, management of suspected and positive COVID-19 cases, personal protective equipment, hospital environments and intra-institutional meetings and tumor board management. Due to the guidelines set out by the Ministry of Health, oncological follow-up visits were interrupted during the lockdown-phase I; consequently, we set about contacting patients by telephone, with laboratory and instrumental exams being viewed via telematics. During the post-lockdown-phase II, the oncological follow-up clinic reopened, with two shifts operating daily. Results By comparing our radiotherapy activity from March 9 to May 4 2019 with the same period in 2020 during full phase I of the COVID-19 emergency, similar results were achieved. First radiotherapy visits, Simulation Computed Tomography and Linear Accelerator treatments amounted to 123, 137 and 151 in 2019 compared with 121, 135 and 170 in 2020 respectively. There were no cases of COVID-19 positivity recorded either in patients or in healthcare professionals, who were all negative to the swab tests performed. Conclusion During both phases of the COVID-19 emergency, the planned model used in our own experience guaranteed both continuity in radiotherapy treatments whilst neither reducing workload nor interrupting treatment and, as such, it ensured the safety of cancer patients, hospital environments and staff.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Open Accessmentioning

confidence: 99%

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COVID-19 and radiation oncology: the experience of a two-phase plan within a single institution in central Italy

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“…The transition towards P2 brought important modifications in the emergency setting of the RT Departments in Lombardy, which have started to gradually resume normal activities. Previous surveys have already investigated the effect of pandemic on RT centres in USA [ 10 ], Europe [ 11 ], Italy [ 1 ] and Lombardy [ 2 ]. The present study represents a continuation of the one conducted in Lombardy during P1 [ 1 ] and aims at investigating, by means of a questionnaire, how Lombardian RT facilities have faced up the recovery during P2.…”

Section: Introductionmentioning

confidence: 99%

Back to (new) normality—A CODRAL/AIRO-L survey on cancer radiotherapy in Lombardy during Italian COVID-19 phase 2

et al. 2020

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Background Italy experienced one of the world’s severest COVID-19 outbreak, with Lombardy being the most afflicted region. However, the imposed safety measures allowed to flatten the epidemic curve and hence to ease the restrictions and inaugurate, on the 4th of May 2020, the Italian phase (P) 2 of the pandemic. The present survey study, endorsed by CODRAL and AIRO-L, aimed to assess how radiotherapy (RT) departments in Lombardy have dealt with the recovery. Materials and methods A questionnaire dealing with the management of pandemic was developed online and sent to all CODRAL Directors on the 10th of June 2020. Answers were collected in full anonymity one week after. Results All the 33 contacted RT facilities (100%) responded to the survey. Despite the scale of the pandemic, during P1 14 (42.4%) centres managed to safely continue the activity (≤ 10% reduction). During P2, 10 (30.3%) centres fully recovered and 14 (42.4%) reported an increase. Nonetheless, 6 (18.2%) declared no changes and, interestingly, 3 (9.1%) reduced activities. Overall, 21 centres (63.6%) reported suspected or positive cases within healthcare workforce since the beginning of the pandemic. Staff units were quarantined in 19 (57.6%) and 6 (18.2%) centres throughout P1 and P2, respectively. In the two phases, about two thirds centres registered positive or suspected cases amongst patients. Conclusion The study revealed a particular attention to anti-contagion measures and a return to normal or even higher clinical workload in most RT centres in Lombardy, necessary to carry out current and previously deferred treatments. Electronic supplementary material The online version of this article (10.1007/s12032-020-01434-1) contains supplementary material, which is available to authorized users.

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“…Regarding pancreatic cancer (PC), the ESMO recommendations in the COVID-19 era [1] consider as "high priority to treat" newly diagnosed resectable PC and locally advanced PC (LAPC). Since, radiotherapy (RT) is an essential component of oncological curative therapy, in this era a shorter RT should be preferred to conventional schedule and, when possible, surgery delayed [2]. The surgical related length of hospitalization, the high risk of pulmonary and postoperative morbidity [3] are unfavourable circumstances to be weighted.…”

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confidence: 99%

Pancreatic cancer: Does a short course of carbon ion radiotherapy worth during COVID-19 outbreak?

et al. 2020

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. Letter to Editor Pancreatic cancer: Does a short course of carbon ion radiotherapy worth during COVID-19 outbreak?

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COVID-19 Outbreak and Cancer Radiotherapy Disruption in Lombardy, Northern Italy

Cited by 28 publications

References 0 publications

COVID-19 and radiation oncology: the experience of a two-phase plan within a single institution in central Italy

COVID-19 and radiation oncology: the experience of a two-phase plan within a single institution in central Italy

Back to (new) normality—A CODRAL/AIRO-L survey on cancer radiotherapy in Lombardy during Italian COVID-19 phase 2

Pancreatic cancer: Does a short course of carbon ion radiotherapy worth during COVID-19 outbreak?

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