Teckie Sewit, Andrews Janna Zeola, Chen William Chun-Ying, Goenka Anuj, Koffler Daniel, Adair Nilda, Potters Louis
Academic Department of Radiation Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY.
JCO Oncol Pract. 2021 Sep;17(9):e1270-e1277. doi: 10.1200/OP.20.00619. Epub 2021 Feb 2.
During the COVID-19 surge months of March and April 2020, our New York multicenter health system experienced an influx of cases with COVID-19. We sought to study the impact of the surge period on patients with cancer prescribed radiation treatment (RT).
We reviewed our secure departmental quality assurance database for all patients who underwent RT planning simulations from March 6, 2020, through April 30, 2020. A priority level between 1 and 3 was prospectively assigned to each case based on faculty consensus to determine which patients required immediate RT. In May 2020, each faculty physician again retrospectively reviewed their patients from the database and provided additional commentary on how the COVID-19 pandemic had affected each patient's care. All statistics are descriptive.
A total of 412 RT courses in 406 unique patients were simulated for linear accelerator-based external beam RT. The median age was 66 years. Treatment intent was curative in 70.6% and palliative in 29.4%. Of the 412 cases, 66.7% were priority 1, 25% priority 2, and 7.8% priority 3. Two hundred thirty-nine cases (58%) underwent standard-of-care diagnosis, workup, and treatment plan. Seventeen patients (4.1%) electively canceled their RT, and 17 others (4.1%) electively delayed RT start. Thirty-four (8.3%) were prescribed hypofractionation to shorten their RT course, and 22 (5.3%) had a change in modality. Incomplete or delayed workup was identified in 19 cases (4.6%).
The COVID-19 pandemic surge resulted in 42% of our patients having a non-standard-of-care pathway. This outcome demonstrates a significant impact of the COVID-19 crisis on routine cancer care.
在2020年3月和4月新冠疫情高峰期，我们纽约的多中心医疗系统迎来了大量新冠病例。我们试图研究这一高峰期对接受放射治疗（RT）的癌症患者的影响。
我们查阅了安全的部门质量保证数据库，该数据库涵盖了2020年3月6日至2020年4月30日期间接受放疗计划模拟的所有患者。根据教员的共识，前瞻性地为每个病例分配1至3级的优先级，以确定哪些患者需要立即进行放疗。2020年5月，每位教员再次回顾数据库中的患者，并就新冠疫情如何影响每位患者的治疗提供了额外的评论。所有统计数据均为描述性的。
共为406名独特患者的412个放疗疗程进行了基于直线加速器的外照射放疗模拟。中位年龄为66岁。治疗目的为治愈性的占70.6%，姑息性的占29.4%。在412例病例中，66.7%为1级优先级，25%为2级优先级，7.8%为3级优先级。239例（58%）接受了标准的诊断、检查和治疗计划。17名患者（4.1%）选择性取消了放疗，另外17名患者（4.1%）选择性推迟了放疗开始时间。34例（8.3%）被规定采用大分割放疗以缩短放疗疗程，22例（5.3%）改变了治疗方式。19例（4.6%）发现检查不完整或延迟。
新冠疫情高峰期导致42%的患者未采用标准治疗路径。这一结果表明新冠危机对常规癌症护理产生了重大影响。
