Managing a radiotherapy center safely and efficiently using risk-adaptive strategies during coronavirus disease pandemic: Experience from national cancer center of China

Bi, Nan; Yi, Junlin; Dai, Jing; Wang, Shulian; Zhou, Zongmei; Men, Kuo; Jin, Jing; Gao, Shugeng; Li, Yexiong; He, Jie

doi:10.1016/j.radonc.2020.05.031

Cited by 6 publications

(7 citation statements)

References 4 publications

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“…Positive COVID-19 cases did not affect the changes in whole sample; however, non-university clinics with positive patients reported significantly more changes to follow-up visits by telephone. [15][16][17][18][19][20][21]. In March 2020, ARO, DEGRO and the professional association for radiation oncology during the COVID-19 pandemic (https://www.degro.org/stellungnahme-der-aro-degro-unddes-berufsverbandes-zur-strahlentherapie-waehrend-dercovid-19-pandemie) released a statement with suggestions on the treatment of patients suspected of SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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“…Salvage radiotherapy was practicable, such as weekend treatments or increased number of daily fractions; increased dose per fraction; delivering extra fractions [6]. Balancing the risks of infection and subsequent mortality with the increased risks of cancer mortality derived from delaying treatment is of utmost importance, to date, many cancer centers have shared their strategies and experiences, which were effective in protecting the patient and staff from infection [7][8][9]. Further follow-up may clearly demonstrate the consequence of treatment interruption on local control and survival of cancer patients.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

Effect of radiotherapy interruption due to COVID-19 outbreak

Chen

et al. 2021

Radiotherapy and Oncology

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To the EditorThe impact of the COVID-19 pandemic on cancer death was reported recently [1]. Wuhan where COVID-19 broke out has been critically hit [2,3]. The emergence has affected every aspect of health care, including the delivery of standard radiotherapy to patients with cancer. Those patients was facing disruption because of concerns about their susceptibility to the serious risks of COVID-19, travel restrictions, and the shortage of personnel, beds and personal protective equipment, and it has been reported that many cancer patients in hospitals of Wuhan got into such difficulties, so the number of patients receiving radiotherapy significantly decreased during the pandemic [4,5].The radiotherapy center of Renmin Hospital of Wuhan University (RHWU) was shut down on January 24, and reopened until March 9, 2020. Thus, many patients were unplanned interrupted of radiotherapy during this period. Our survey of 140 consecutive patients in RHWU from March 9 to June 30, 2020, summarizes the clinical characteristics and outcome of these patients whose radiotherapy interrupted for 45 days or longer.

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“…In March 2020, COVID-19 was declared a pandemic by the World Health Organization oncology departments worldwide. The first such publications came out of early pandemic hotspots such as China, 1,2 Italy, 3,4 and the United States. [5][6][7][8][9] These publications describe best practices for operating radiation oncology departments during a growing pandemic.…”

Section: Introductionmentioning

confidence: 99%

The impact of COVID‐19 on a high‐volume incident learning system: A retrospective analysis

Jacqmin

Crosby

2022

J Applied Clin Med Phys

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Purpose The purpose of this work was to assess how the coronavirus disease 2019 (COVID‐19) pandemic impacted our incident learning system data and communicate the impact of a major exogenous event on radiation oncology clinical practice. Methods Trends in our electronic incident reporting system were analyzed to ascertain the impact of the COVID‐19 pandemic, including any direct clinical changes. Incident reports submitted in the 18 months prior to the pandemic (September 14, 2018 to March 13, 2020) and reports submitted during the first 18 months of the pandemic (March 14, 2020 to September 13, 2021) were compared. The incident reports include several data elements that were evaluated for trends between the two time periods, and statistical analysis was performed to compare the proportions of reports. Results In the 18 months prior to COVID‐19, 192 reports were submitted per 1000 planning tasks (n = 832 total). In the first 18 months of the pandemic, 147 reports per 1000 planning tasks were submitted (n = 601 total), a decrease of 23.4%. Statistical analysis revealed that there were no significant changes among the data elements between the pre‐ and during COVID‐19 time periods. An analysis of the free‐text narratives in the reports found that phrases related to pretreatment imaging were common before COVID‐19 but not during. Conversely, phrases related to intravenous contrast, consent for computed tomography, and adaptive radiotherapy became common during COVID‐19. Conclusions The data elements captured by our incident learning system were stable after the onset of the COVID‐19 pandemic, with no statistically significant findings after correction for multiple comparisons. A trend toward fewer reports submitted for low‐risk issues was observed. The methods used in the work can be generalized to events with a large‐scale impact on the clinic or to monitor an incident learning system to drive future improvement activities.

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Managing a radiotherapy center safely and efficiently using risk-adaptive strategies during coronavirus disease pandemic: Experience from national cancer center of China

Cited by 6 publications

References 4 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

Effect of radiotherapy interruption due to COVID-19 outbreak

The impact of COVID‐19 on a high‐volume incident learning system: A retrospective analysis

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