Radiothérapie mammaire dans le contexte de la pandémie de COVID-19 : astuces pratiques en période épidémique et conseils pour la reprise de l’activité en fin de crise

Loap, Pierre; Kirova, Youlia; Takanen, Silvia; Créhange, G.

doi:10.1016/j.canrad.2020.04.004

Cited by 12 publications

(3 citation statements)

References 11 publications

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“…Loap et al [ 26 ] reminded that older adult BC patients with favourable prognostic factors who did not receive RT had a significantly increased risk of LR at 5 and 10 years of 4% (vs 1% with RT) and 10% (vs 2% with RT) respectively. Consequently, they suggested hypofractionated regimens (32.5 Gy in 5 weekly fractions, or 28.5 Gy in 5 daily fractions) instead of RT omission for the oldest patients (>80 years).…”

Section: Resultsmentioning

confidence: 99%

Omission of adjuvant radiotherapy for older adults with early-stage breast cancer particularly in the COVID era: A literature review (on the behalf of Italian Association of Radiotherapy and Clinical Oncology)

Palumbo

Borghesi

Gregucci³

et al. 2021

Journal of Geriatric Oncology

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This review is aimed at evaluating whether radiation therapy (RT) can be omitted in older adult early-stage lowrisk breast cancer (BC) patients. The published data are particularly relevant at present, during the COVID-19 pandemic emergency, to define a treatment strategy and to prioritize essential therapy. Cochrane Database of Systematic Reviews and PubMED were systematically researched from outset through April 2020 using Mesh terms. Only randomized controlled trials (RCT), with one arm without adjuvant wholebreast irradiation (WBI), were included in the analysis. Recent literature regarding the COVID pandemic and BC RT was assessed. The reported RCTs identified a group of BC patients (pT1-2N0M0 R0, grade 1-2, estrogen receptor (ER) positive, human epidermal growth factor receptor 2 (HER2) negative tumours) in which the absolute risk of local recurrence (LR) was considered low enough to omit RT. The most common risk factors were tumor diameter, nodal and receptor status. Adjuvant RT had a significant impact on LR but not on distant metastasis (DM) or death. During the COVID 19 pandemic, results from RTCs were re-considered to define treatment recommendations for BC patients. International scientific societies and radiation oncology experts suggested RT omission, whenever possible, in older adult early-stage BC patients. Adjuvant RT might be omitted in a highly selected group of older adult early-stage BC patients with favourable prognostic factors. Hypofractionated regimens should be the standard. RT omission, partial breast irradiation (PBI), and ultra-hypofractionated regimens could be considered in selected cases due to the pandemic.

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Section: Resultsmentioning

confidence: 99%

Omission of adjuvant radiotherapy for older adults with early-stage breast cancer particularly in the COVID era: A literature review (on the behalf of Italian Association of Radiotherapy and Clinical Oncology)

Palumbo

Borghesi

Gregucci³

et al. 2021

Journal of Geriatric Oncology

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“…Supraclavicular and internal breast node area were irradiated according to local thesaurus, with dosing between 46 and 50 Gy, in 23 to 25 fractions. Owing to the COVID-19 pandemia, dosing regimen, fractionating in breast irradiation required specific adaptations, in compliance with international guidelines [29] , [30] , and breast and parietal area doses were changed to 40.05 Gy in 15 fractions of 2.67 Gy, 5 times a week. If a boost was required, a dose of 10 Gy in 4 fractions of 2.5 Gy, 4 times a week may be administrated.…”

Section: Patient and Methodsmentioning

confidence: 99%

Cicaderma® in radiation–related dermatitis of breast cancer: Results from the multicentric randomised phase III CICA-RT

Racadot

Arnaud

Schiffler

et al. 2023

Clinical and Translational Radiation Oncology

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“…5 Â 5 Gy). For breast cancer patients that had already begun RT and patients for whom irradiation (either for breast cancer or palliative treatment) was about to be started (planning in progress or completed but treatment not started), the number of sessions was adapted, giving priority to hypofractionation (workflow ''adapt-COVID") [17]. For patients whose treatment was not yet planned and whose start could be postponed for a few months, a new workflow called ''break-COVID" was created and used to: (1) evaluate and identify the patients with delayed interventions during the crisis (delayed CTscans, delayed treatment starts); (2) ensure the qualitative follow-up of delayed cases; (3) ensure the qualitative and quantitative follow-up of prescription changes; (4) resume treatment starts when the crisis is over by pushing forward the cases that were ready to start.…”

mentioning

confidence: 99%

Post-lockdown management of oncological priorities and postponed radiation therapy following the COVID-19 pandemic: Experience of the Institut Curie

Beddok

Calugaru

Minsat

et al. 2020

Radiotherapy and Oncology

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In France, as in most countries, strict strategies were implemented in cancer hospitals to reduce the spread of coronavirus , but to maintain as much as possible the capacity of oncology health services [1,2]. These strategies included the reduction of elective services, an emphasis on remote visits, and the use of personal protective equipment [3][4][5][6][7]. International radiation therapy (RT) academic societies proposed to restrict the indications for treatment [8], to delay as long as possible the start of nonurgent treatments and to prefer hypofractionated regimens [9][10][11][12][13][14][15][16]. To our knowledge, none of these recommendations anticipated how to handle the load of delayed treatments after the lockdown. However, the successful management of cancer treatments during lockdown undoubtedly correlates with the successful management of post-lockdown activity overload.The Institut Curie has one of the largest RT departments in Europe. It is spread over three separate sites in the Paris area and has a total of eleven LINACs (six in Paris, four in Saint-Cloud and one in Orsay) and three treatment rooms for proton therapy in Orsay. In 2019, 5,860 patients were treated and the average number of treatment essions per month delivered was 8931, comprising 4183 sessions in Paris, 3303 in Saint-Cloud and 1445 in Orsay. In order to comply with the international recommendations mentioned above, several measures had to be applied in our department to protect both patients and operators from the risk of contamination. The challenges of post-crisis management following the COVID-19 pandemic therefore had to be anticipated. Here, we propose some key considerations to prepare for the post-lockdown period by pre-

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Radiothérapie mammaire dans le contexte de la pandémie de COVID-19 : astuces pratiques en période épidémique et conseils pour la reprise de l’activité en fin de crise

Cited by 12 publications

References 11 publications

Omission of adjuvant radiotherapy for older adults with early-stage breast cancer particularly in the COVID era: A literature review (on the behalf of Italian Association of Radiotherapy and Clinical Oncology)

Omission of adjuvant radiotherapy for older adults with early-stage breast cancer particularly in the COVID era: A literature review (on the behalf of Italian Association of Radiotherapy and Clinical Oncology)

Cicaderma® in radiation–related dermatitis of breast cancer: Results from the multicentric randomised phase III CICA-RT

Post-lockdown management of oncological priorities and postponed radiation therapy following the COVID-19 pandemic: Experience of the Institut Curie

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