Regional Lymph Node Irradiation in Breast Cancer May Worsen Lung Damage in Coronavirus Disease 2019 Positive Patients

Grellier, N.; Hadhri, A.; Bendavid, Jérôme; Adou, Marie; Demory, Alix; Bouchereau, Sarah; Hassani, Wissal; Hervé, M.L.; Mahé, Mathilde; Colson-Durand, Laurianne; Belkacémi, Yazid

doi:10.1016/j.adro.2020.04.033

Cited by 8 publications

(10 citation statements)

References 10 publications

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“…However, in prostate and breast cancer, this is generally true only for limited irradiation volume in patients without extended nodal RT. Large volume of lung RT could increase the risk of lung damage if the patient became infected by COVID-19 during RT and developed severe respiratory acute syndrome [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

A review of the international early recommendations for departments organization and cancer management priorities during the global COVID-19 pandemic: applicability in low- and middle-income countries

Belkacémi

Grellier

Ghith

et al. 2020

European Journal of Cancer

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Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new virus that has never been identified in humans before. COVID-19 caused at the time of writing of this article, 2.5 million cases of infections in 193 countries with 165,000 deaths, including two-third in Europe. In this context, Oncology Departments of the affected countries had to adapt quickly their health system care and establish new organizations and priorities. Thus, numerous recommendations and therapeutic options have been reported to optimize therapy delivery to patients with chronic disease and cancer. Obviously, while these cancer care recommendations are immediately applicable in Europe, they may not be applicable in certain emerging and low- and middle-income countries (LMICs). In this review, we aimed to summarize these international guidelines in accordance with cancer types, making a synthesis for daily practice to protect patients, staff and tailor anti-cancer therapy delivery taking into account patients/tumour criteria and tools availability. Thus, we will discuss their applicability in the LMICs with different organizations, limited means and different constraints.

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Section: Discussionmentioning

confidence: 99%

A review of the international early recommendations for departments organization and cancer management priorities during the global COVID-19 pandemic: applicability in low- and middle-income countries

Belkacémi

Grellier

Ghith

et al. 2020

European Journal of Cancer

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“…21 However, even if hypofractionation schedules are advocated by recent recommendations during the COVID-19 crisis, 13 they should be used with high caution in patients with regional node RT, as lung damage caused by COVID 19 infection may be worsened by prior or ongoing lung radiationexposure. 22 For all previously planned additional boosts, we also decided to change fractionation. The scheme of the 10 Gy boost in 4 fractions was mainly planned.…”

Section: Discussionmentioning

confidence: 99%

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

Belkacémi

Loaganadane

Grellier

et al. 2020

Advances in Radiation Oncology

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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.

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“…Patients who have completed neoadjuvant therapy who lack therapeutic targets (i.e., TNBC) are high priority for preoperative radiation therapy [ 33 ]. Despite the COVID-19 pandemic, delays in radiation are not advised due to the risk of recurrence [ 10 , 46 ]. It is recommended that radiation therapy be administered within 16 weeks following the conclusion of chemotherapy or surgery [ 27 ].…”

Section: Traditional Tnbc Therapiesmentioning

confidence: 99%

Triple-Negative Breast Cancer and the COVID-19 Pandemic: Clinical Management Perspectives and Potential Consequences of Infection

Brown

Wasson

Marcato

2021

Cancers

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The COVID-19 pandemic has caused the need for prioritization strategies for breast cancer treatment, where patients with aggressive disease, such as triple-negative breast cancer (TNBC) are a high priority for clinical intervention. In this review, we summarize how COVID-19 has thus far impacted the management of TNBC and highlighted where more information is needed to hone shifting guidelines. Due to the immunocompromised state of most TNBC patients receiving treatment, TNBC management during the pandemic presents challenges beyond the constraints of overburdened healthcare systems. We conducted a literature search of treatment recommendations for both primary and targeted TNBC therapeutic strategies during the COVID-19 outbreak and noted changes to treatment timing and drugs of choice. Further, given that SARS-CoV-2 is a respiratory virus, which has systemic consequences, management of TNBC patients with metastatic versus localized disease has additional considerations during the COVID-19 pandemic. Published dataset gene expression analysis of critical SARS-CoV-2 cell entry proteins in TNBCs suggests that the virus could in theory infect metastasized TNBC cells it contacts. This may have unforeseen consequences in terms of both the dynamics of the resulting acute viral infection and the progression of the chronic metastatic disease. Undoubtedly, the results thus far suggest that more research is required to attain a full understanding of the direct and indirect clinical impacts of COVID-19 on TNBC patients.

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Regional Lymph Node Irradiation in Breast Cancer May Worsen Lung Damage in Coronavirus Disease 2019 Positive Patients

Cited by 8 publications

References 10 publications

A review of the international early recommendations for departments organization and cancer management priorities during the global COVID-19 pandemic: applicability in low- and middle-income countries

A review of the international early recommendations for departments organization and cancer management priorities during the global COVID-19 pandemic: applicability in low- and middle-income countries

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

Triple-Negative Breast Cancer and the COVID-19 Pandemic: Clinical Management Perspectives and Potential Consequences of Infection

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