Radiation Therapy Department Reorganization during the Coronavirus Disease 2019 (COVID-19) Outbreak: Keys to Securing Staff and Patients During the First Weeks of the Crisis and Impact on Radiation Therapy Practice from a Single Institution Experience

Abstract

During the first weeks of the coronavirus disease 2019 outbreak in France, it was necessary to clearly define organizational priorities in the radiation therapy (RT) departments. In this report, we focus on the urgent measures taken to reduce risk for both our staff and patients by reducing the number of patients receiving treatment. Methods and Materials: We reviewed the fractionation schemes for all patients in our department, including those receiving treatment and those soon to start treatment. Our goals were to (1) decrease the number of patients coming daily to the hospital for RT, (2) adapt our human resources to continue patients' care in the department, and (3) help to cover understaffed COVID-19 sectors of the hospital.

Radiation Therapy Delivery Challenges in Older Patients During Coronavirus Disease 2019 Pandemic

“…Multidisciplinary treatment decision was based on international guidelines ( 9 , 10 ) and on individual comprehensive geriatric assessment during the oncogeriatric visit. We used prospectively a clinical frailty scale according to Rockwood Frailty index which is a multidimensional approach.…”

“…Apart from reassessing indications for radiation and postponing whenever possible, strong protective measures were applied for patients: reduced number of visits to the clinic (hypofractionation, telemedicine), individual preventive actions (hand washing, wearing of masks), and collective preventive actions: social distancing, screening by front desk staff upon check-in, sanitization (waiting room, devices, treatment couch) and individual transportation. The organizational procedures implemented in the early stages of the Covid-19 pandemic in our department were previously reported ( 9 ).…”

“…The organizational procedures implemented in the early stages of the COVID-19 pandemic in our department were previously reported. 8 In older patients, the decision to defer radiation therapy or the use of hypofractionation schedules was taken in weekly chart rounds in presence of a radiation oncologists specialized in geriatrics considering comorbidities and frailty of the individual.…”

“…Here we report our experience with elderly patients referred to our department during the lockdown. We will describe a personalized care plan ( 9 ) following the guidelines from the international early recommandations for departments organization and cancer management during COVID-19 pandemic ( 10 ) in the context of the outbreak, taking into account various aspects of geriatric frailty.…”

Challenges faced by women in radiology during the pandemic - A summary of the AAWR Women's Caucus at the ACR 2020 annual meeting

“…As cancer patients are immunocompromised, social distancing and hygiene practices in the department have been multifold. Safety measures include routine testing of patients at various time points in the treatment process, treating COVID-19 positive patients at the very end of the day followed by rigorous cleaning of linear accelerators, rotating healthcare personnel to protect workers and re-distributing workload in case someone becomes ill, converting all tumor boards and meetings to virtual formats, allowing one accompanying visitor for patients requiring a chaperone (otherwise, no visitors) and teleconferencing any visit that does not require a physical exam [10,11]. Many centers have reported an initial decrease in volume followed by an uptrend.…”