GOECP/SEOR clinical recommendations for lung cancer radiotherapy during the COVID-19 pandemic

Couñago, Felipe; Navarro-Martín, Arturo; Luna, J.; Dios, N. Rodriguez De; Rodríguez, A.; Casas, Francesc; García, Rafael; Gómez-Caamaño, Antonio; Contreras, Jorge; Serrano, Javier García

doi:10.5306/wjco.v11.i8.510

Cited by 18 publications

(18 citation statements)

References 99 publications

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“…These efforts were led by the tumor group chairs and the chairs of the tumor group sub-committees. SF lung SABR was identified by the provincial lung radiation oncology sub-committee as a mitigation measure supported by high-quality randomized evidence that could provide comparable outcomes and toxicity to existing fractionated SABR protocols [9][10][11] and was also endorsed by international expert panels [2][3][4][5][6]. Lung SABR has been used in routine clinical practice in BC since 2008 and is practiced in all six centers.…”

Section: Methodsmentioning

confidence: 99%

“…The treatment of lung cancer is especially challenging in the midst of a pandemic characterized by respiratory system compromise, as these patients are at risk from both COVID-19 as well as their underlying malignancy [1]. International experts published consensus guidelines on managing lung cancer patients with radiotherapy during the early months of the pandemic [2][3][4][5][6]. The recommendations from these guidelines highlight reducing treatments for early-stage non-small-cell lung cancer (NSCLC) down to a single fraction (SF) of 30-34 Gy using stereotactic ablative radiotherapy (SABR) for selected peripherally located tumors.…”

Section: Introductionmentioning

confidence: 99%

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Implementation of Single-Fraction Lung Stereotactic Ablative Radiotherapy in a Multicenter Provincial Cancer Program During the COVID-19 Pandemic

Mou¹,

Hyde²,

Araujo³

et al. 2021

Cureus

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BackgroundDuring the novel coronavirus disease 2019 (COVID-19) pandemic, cancer centers considered shortened courses of radiotherapy to minimize the risk of infectious exposure of patients and staff members. Amidst a pandemic, the process of implementing new treatment approaches can be particularly challenging in larger institutions with multiple treatment centers. We describe the implementation of single-fraction (SF) lung stereotactic ablative radiotherapy (SABR) in a multicenter provincial cancer program. Materials and MethodsBritish Columbia, Canada has a provincial cancer program with six geographically distributed radiotherapy centers serving a population of 5.1 million, over 944,735 square kilometers. In March 2020, provincial mitigation strategies were developed in case of reduced access to radiotherapy due to the COVID-19 pandemic. SF lung SABR was identified by the provincial lung radiation oncology group as a mitigation measure supported by high-quality randomized evidence that could provide comparable outcomes and toxicity to existing fractionated SABR protocols. A working group consisting of radiation oncologists and medical physicists reviewed the medical literature and drafted consensus guidelines that were reviewed by a group of center representatives as a component of provincial lung radiotherapy mitigation strategic planning. Individual centers were encouraged to implement SF lung SABR as their resources and staffing would allow. Centers were then surveyed about barriers to implementation. ResultsOn March 24, 2020, a working group was created and consensus guidelines for SF lung SABR were drafted. The final version was approved and distributed by the working group on March 26, 2020. The provincial lung radiotherapy mitigation strategy group adopted the guidelines for implementation on April 1, 2020. Implementation was completed at the first center on April 27, 2020. Barriers to implementation were identified at five of six centers. Two centers in regions with disproportionately high COVID-19 cases described inadequate staffing as a barrier to implementation. One center encountered delays due to prescheduled commissioning of new treatment techniques. Three centers cited competing priorities as reasons for delay. As of May 2021, two centers had active SF lung SABR programs in place, three centers were in the process of implementation, and one center had no immediate plans for implementation due to ongoing resource issues. ConclusionSF lung SABR was adopted by a provincial cancer program within weeks of conception through rapid communication during the development of COVID-19 pandemic mitigation strategies for radiotherapy. Although consensus guidelines were written and approved in an expedited timeframe, the completion of implementation by individual centers was variable due to differences in resource allocation and staffing among the centers. Strong organizational structures and early identification of potential barriers may improve the efficiency of implementing new treatment initiatives in larg...

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Implementation of Single-Fraction Lung Stereotactic Ablative Radiotherapy in a Multicenter Provincial Cancer Program During the COVID-19 Pandemic

Mou¹,

Hyde²,

Araujo³

et al. 2021

Cureus

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“…Finally, the Spanish Society of Radiation Oncology, along with other entities, regularly provide updated treatment recommendations on radiotherapy for lung cancer. 16…”

Section: Lap B1 Lap B2mentioning

confidence: 99%

Lung Cancer in Spain

Remón

Reguart

García‐Campelo

et al. 2021

Journal of Thoracic Oncology

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“…During the coronavirus disease 2019 (COVID-19) pandemic, treatment recommendations for cancer have emphasized delivering high-quality care while minimizing in-person interactions between patients and healthcare providers [1]. For medically inoperable patients with early stage non-small cell lung cancer (NSCLC) or lung oligometastases, a range of treatment guidelines has supported stereotactic body radiation therapy (SBRT) [2][3][4][5][6]. Several prospective studies have substantiated the therapeutic utility of SBRT as a surgical alternative, with long-term local control rates of ~90% at 5 years [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Systematic Review of Single-Fraction Stereotactic Body Radiation Therapy for Early Stage Non-Small-Cell Lung Cancer and Lung Oligometastases: How to Stop Worrying and Love One and Done

Bartl

Mahoney

Hennon

et al. 2022

Cancers

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Adoption of single-fraction lung stereotactic body radiation therapy (SBRT) for patients with medically inoperable early stage non-small-cell lung cancer (NSCLC) or oligometastatic lung disease, even during the coronavirus disease 2019 (COVID-19) pandemic, was limited despite encouraging phase II trial results. Barriers to using single-fraction SBRT may include lack of familiarity with the regimen and lack of clarity about the expected toxicity. To address these concerns, we performed a systematic review of prospective literature on single-fraction SBRT for definitive treatment of early stage and oligometastatic lung cancer. A PubMed search of prospective studies in English on single-fraction lung SBRT was conducted. A systematic review was performed of the studies that reported clinical outcomes of single-fraction SBRT in the treatment of early stage non-small-cell lung cancer and lung oligometastases. The current prospective literature including nine trials supports the use of single-fraction SBRT in the definitive treatment of early stage peripheral NSCLC and lung oligometastases. Most studies cite local control rates of >90%, mild toxicity profiles, and favorable survival outcomes. Most toxicities reported were grade 1–2, with grade ≥3 toxicity in 0–17% of patients. Prospective trial results suggest potential consideration of utilizing single-fraction SBRT beyond the COVID-19 pandemic.

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GOECP/SEOR clinical recommendations for lung cancer radiotherapy during the COVID-19 pandemic

Cited by 18 publications

References 99 publications

Implementation of Single-Fraction Lung Stereotactic Ablative Radiotherapy in a Multicenter Provincial Cancer Program During the COVID-19 Pandemic

Implementation of Single-Fraction Lung Stereotactic Ablative Radiotherapy in a Multicenter Provincial Cancer Program During the COVID-19 Pandemic

Lung Cancer in Spain

Systematic Review of Single-Fraction Stereotactic Body Radiation Therapy for Early Stage Non-Small-Cell Lung Cancer and Lung Oligometastases: How to Stop Worrying and Love One and Done

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