Management and Outcomes of Patients With Radiotherapy Interruption During the COVID-19 Pandemic

PurposeThis retrospective observational study examined patients who experienced radiotherapy (RT) interruption during the Wuhan lockdown for the novel coronavirus disease 2019 (COVID-19) pandemic.Materials and MethodsThe data of all patients whose RT was interrupted during the Wuhan lockdown from Ja...

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Autores principales: Xiaofang Ying, Jianping Bi, Yi Ding, Xueyan Wei, Wei Wei, Fang Xin, Chuangying Xiao, Desheng Hu, Vivek Verma, Guang Han
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Publicado: Frontiers Media S.A. 2021
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Acceso en línea:https://doaj.org/article/75169afa8f72466db10fec992036d8fc
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spelling oai:doaj.org-article:75169afa8f72466db10fec992036d8fc2021-11-19T05:24:58ZManagement and Outcomes of Patients With Radiotherapy Interruption During the COVID-19 Pandemic2234-943X10.3389/fonc.2021.754838https://doaj.org/article/75169afa8f72466db10fec992036d8fc2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.754838/fullhttps://doaj.org/toc/2234-943XPurposeThis retrospective observational study examined patients who experienced radiotherapy (RT) interruption during the Wuhan lockdown for the novel coronavirus disease 2019 (COVID-19) pandemic.Materials and MethodsThe data of all patients whose RT was interrupted during the Wuhan lockdown from January 23 to April 8, 2020 were collected. Patient-, cancer-, and treatment-related characteristics were analyzed, along with interruption time, disease progression type, and survival status. The methods employed in order to compensate for RT interruption were also described.ResultsThere were altogether 129 cancer patients whose RT was interrupted. Nineteen (14.7%) patients experienced a total interruption time of at most 7 days; the interruption time was 8–14 days for 27 (20.9%) patients, and 15 or more days for 47 (36.4%) patients. The remaining 36 (27.9%) patients did not come back to our hospital for further RT. We first describe our experience with re-immobilization and/or re-planning (n = 17) as well as dose compensation/adjustment. Of the 40 definitive radiotherapy patients, 37 had squamous cell carcinoma of nasopharyngeal, lung, or cervical origin. Most patients (85/93, 91.4%) were followed up for more than one year. Among the 40 patients who received definitive radiotherapy, nine patients experienced disease progression and five patients died. Three of the seven (42.9%) patients who did not finish radiotherapy after interruption died, as compared to only two of the 33 (6.1%) patients who completed radiotherapy. EQD2 (equivalent dose in 2 Gy fractions) at the time point of RT interruption was calculated. Five of the six patients (83.3%) who received EQD2 ≤10 Gy suffered from disease progression, compared with four of the 34 (11.8%) patients who received EQD2 >10 Gy. For the seven definitive radiotherapy cases who did not finish radiotherapy, three received systemic anti-cancer treatments and three died (all of whom did not receive further systemic therapies).ConclusionsThis study provides the longest follow-up for the outcomes of RT interruption during COVID-19 pandemic to date. It cannot imply causation but implies that completing RT is important, along with the utility of having patients remain on systemic therapies if RT is to be interrupted.Xiaofang YingJianping BiYi DingXueyan WeiWei WeiFang XinChuangying XiaoDesheng HuVivek VermaGuang HanFrontiers Media S.A.articleCOVID-19 pandemicradiotherapyinterruptionoutcomesdistant metastasisNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution DOAJ
collection DOAJ
language EN
topic COVID-19 pandemic
radiotherapy
interruption
outcomes
distant metastasis
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
spellingShingle COVID-19 pandemic
radiotherapy
interruption
outcomes
distant metastasis
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Xiaofang Ying
Jianping Bi
Yi Ding
Xueyan Wei
Wei Wei
Fang Xin
Chuangying Xiao
Desheng Hu
Vivek Verma
Guang Han
Management and Outcomes of Patients With Radiotherapy Interruption During the COVID-19 Pandemic
description PurposeThis retrospective observational study examined patients who experienced radiotherapy (RT) interruption during the Wuhan lockdown for the novel coronavirus disease 2019 (COVID-19) pandemic.Materials and MethodsThe data of all patients whose RT was interrupted during the Wuhan lockdown from January 23 to April 8, 2020 were collected. Patient-, cancer-, and treatment-related characteristics were analyzed, along with interruption time, disease progression type, and survival status. The methods employed in order to compensate for RT interruption were also described.ResultsThere were altogether 129 cancer patients whose RT was interrupted. Nineteen (14.7%) patients experienced a total interruption time of at most 7 days; the interruption time was 8–14 days for 27 (20.9%) patients, and 15 or more days for 47 (36.4%) patients. The remaining 36 (27.9%) patients did not come back to our hospital for further RT. We first describe our experience with re-immobilization and/or re-planning (n = 17) as well as dose compensation/adjustment. Of the 40 definitive radiotherapy patients, 37 had squamous cell carcinoma of nasopharyngeal, lung, or cervical origin. Most patients (85/93, 91.4%) were followed up for more than one year. Among the 40 patients who received definitive radiotherapy, nine patients experienced disease progression and five patients died. Three of the seven (42.9%) patients who did not finish radiotherapy after interruption died, as compared to only two of the 33 (6.1%) patients who completed radiotherapy. EQD2 (equivalent dose in 2 Gy fractions) at the time point of RT interruption was calculated. Five of the six patients (83.3%) who received EQD2 ≤10 Gy suffered from disease progression, compared with four of the 34 (11.8%) patients who received EQD2 >10 Gy. For the seven definitive radiotherapy cases who did not finish radiotherapy, three received systemic anti-cancer treatments and three died (all of whom did not receive further systemic therapies).ConclusionsThis study provides the longest follow-up for the outcomes of RT interruption during COVID-19 pandemic to date. It cannot imply causation but implies that completing RT is important, along with the utility of having patients remain on systemic therapies if RT is to be interrupted.
format article
author Xiaofang Ying
Jianping Bi
Yi Ding
Xueyan Wei
Wei Wei
Fang Xin
Chuangying Xiao
Desheng Hu
Vivek Verma
Guang Han
author_facet Xiaofang Ying
Jianping Bi
Yi Ding
Xueyan Wei
Wei Wei
Fang Xin
Chuangying Xiao
Desheng Hu
Vivek Verma
Guang Han
author_sort Xiaofang Ying
title Management and Outcomes of Patients With Radiotherapy Interruption During the COVID-19 Pandemic
title_short Management and Outcomes of Patients With Radiotherapy Interruption During the COVID-19 Pandemic
title_full Management and Outcomes of Patients With Radiotherapy Interruption During the COVID-19 Pandemic
title_fullStr Management and Outcomes of Patients With Radiotherapy Interruption During the COVID-19 Pandemic
title_full_unstemmed Management and Outcomes of Patients With Radiotherapy Interruption During the COVID-19 Pandemic
title_sort management and outcomes of patients with radiotherapy interruption during the covid-19 pandemic
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/75169afa8f72466db10fec992036d8fc
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