Suggestions for Radiation Oncologists during the COVID-19 Pandemic

Franco, Pierfrancesco; Kochbati, Lofti; Siano, Marco; Bari, Berardino De

doi:10.1155/2020/4892382

Cited by 9 publications

(13 citation statements)

References 20 publications

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“…However, when, WBI is required, one of the 5 fraction schedules (28–30 Gy in once weekly fractions, or 26 Gy in 5 daily fractions) can be chosen. Boost dose to the tumor bed should be omitted in patients >40 years and/or with low-risk factors for LR [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…However, when, WBI is required, one of the 5 fraction schedules (28-30 Gy in once weekly fractions, or 26 Gy in 5 daily fractions) can be chosen. Boost dose to the tumor bed should be omitted in patients >40 years and/or with low-risk factors for LR [24]. Curigliano et al [25] recommended evaluating RT omission in the light of the local situation, but to reconsider this indication for the individual patient every four weeks.…”

Section: Recommendations During Covid 19 Pandemicmentioning

confidence: 99%

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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%

Section: Recommendations During Covid 19 Pandemicmentioning

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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“…COVID-19 pandemic has resulted in considerable overloading of health care systems in almost all regions of the world. Previous reports have shown that, compared to the normal population, patients with cancer are more prone to develop COVID-19 complications and death as these frail populations have a higher risk of developing severe respiratory manifestations and requiring invasive ventilation (1).…”

Section: Contextmentioning

confidence: 99%

Radiation Therapy for Breast Cancer During the COVID-19 Pandemic in Low Resource Countries: Consensus Statement from the Iranian Society of Radiation Oncology

Mafi

Motlagh

Foudazi³

et al. 2022

Int J Cancer Manag

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Context: COVID-19 pandemic has resulted in considerable overloading of health care systems in almost all regions of the world. Among different malignancies, breast cancer can be considered as a typical example of how the decision-making process for radiation treatment can be adapted to unusual situations. There exist several international guidelines in order to modify radiotherapy treatments during the COVID-19 pandemic, however, some of their recommendations are not applicable in regions with limited resources. In this manuscript, we provided guidance to deliver radiotherapy to patients with breast cancer during the COVID-19 pandemic based on our available nationwide resources. Evidence Acquisition: A team of expert radiation oncologists convened multidisciplinary and cross-institutional meetings and reviewed the major internationally published guidelines and relevant literature in the field of breast radiotherapy during the COVID-19 pandemic in order to establish recommendations for the safe application of radiation regimens based on the national limited resources. Results: Practical guidance in order to deliver radiotherapy to patients with breast cancer during the COVID-19 pandemic based on available nationwide resources was developed. Conclusions: Many of the international recommendations on the breast cancer radiotherapy during COVID-19 outbreak are not applicable in countries with limited resources. Therefore, modifying the guidelines based on the available resources is mandatory in order to achieve the best possible results.

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“…In this publication the author searched for multidisciplinary and expert recommendations to guide potential shift in RT indications and found limited data as of April 2020 when it was published however provides a good summary of the available data at that point. Chen et al and Franco et al provide broader frameworks for prioritization of patients [6,18]. Franco et al also provides guidelines for the management of patients with COVID-19 [18].…”

Section: Indications For/modification Of Rt -Modify Rt When Possible mentioning

confidence: 99%

“…Chen et al and Franco et al provide broader frameworks for prioritization of patients [6,18]. Franco et al also provides guidelines for the management of patients with COVID-19 [18].…”

Section: Indications For/modification Of Rt -Modify Rt When Possible mentioning

confidence: 99%

https://researchopenworld.com/management-of-cancer-patients-undergoing-radiation-therapy-during-the-novel-coronavirus-disease-2019-covid-19-pandemic-a-review-of-the-literature/#

2020

Cancer Stud Ther J

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systemic management and may therefore not necessarily be immunecompromised, as well as the implication for daily attendance to a RT facility and the associated infection risk and how to best mitigate it. Other questions involve the ability to and safety of delaying or altering RT treatment schedules to minimize risk of infection. Important additional considerations abound in particular settings such a RT emergencies and treatment of the COVID-19 positive patient as well as the administration of radioactive isotopes such as radioactive iodine in thyroid patients who then need to self-isolate at home or as inpatients for several days. Since the COVID-19 pandemic has raised unprecedented challenges and questions, with ongoing lack of robust data, periodic review of the available evidence is important to help guide providers and patients in order to enable evidence-based care hence prompting this scoping review. Materials and Methods To carry out the scoping review, publications that specifically addressed the impact and management of cancer patients undergoing radiation therapy in the context of the COVID 19 pandemic were identified in PubMed using the following mesh terms: (("risk"[MeSH Terms] OR "risk"[All Fields]) OR "risk of "[All Fields]) AND ((((((("covid 19"[All Fields] OR "covid 2019"[All Fields]) OR "severe acute respiratory syndrome coronavirus 2"[Supplementary Concept]) OR "severe acute respiratory syndrome coronavirus 2"[All Fields]) OR "2019 ncov"[All Fields]) OR "sars cov 2"[All Fields]) OR "2019ncov"[All Fields]

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Suggestions for Radiation Oncologists during the COVID-19 Pandemic

Cited by 9 publications

References 20 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)

Radiation Therapy for Breast Cancer During the COVID-19 Pandemic in Low Resource Countries: Consensus Statement from the Iranian Society of Radiation Oncology

https://researchopenworld.com/management-of-cancer-patients-undergoing-radiation-therapy-during-the-novel-coronavirus-disease-2019-covid-19-pandemic-a-review-of-the-literature/#

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