Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
JCO Glob Oncol. 2022 Jul;8:e2100365. doi: 10.1200/GO.21.00365.
Delivery of cancer care during the pandemic required adopting various changes in the standard management. We analyzed the impact of the first wave of the COVID-19 pandemic on radiation oncology treatment practices at Tata Memorial Hospital in India.
From March 1 to October 31, 2020, all consecutive patients who attended the radiation oncology department for radiotherapy treatment were included in this study. Electronic medical records, patient files, and telephonic consult were used to collect patient's data including changes in the standard treatment practice, COVID-19 testing and its results, and subsequent impact on radiotherapy treatment. Comparison was done with the same period data of 2019 for the number of the caseload, radiotherapy regimen, referral rates, and noncompliance rates.
Our study included 4,256 patients with a median age of 52 years (interquartile range 41-61 years). There was a significant drop in the new-patient registrations (approximately 63%), radiotherapy consultations (44.9%), and referrals to other centers (27.8%). The reduction in the caseload was highest for genitourinary cases (-58.5%) and the lowest for breast cases (-11.5%) when compared with the 2019 cohort. Among those treated with radical intent, the noncompliance rate was 15%. Hypofractionation was the commonly adopted regimen across all sites. Compared with 2019, the maximum reduction in the average fractions per patient was seen in the breast cancer cases (-8.2 fraction), followed by genitourinary cases (-4.9 fraction). Of the 27.8% of patients tested for COVID-19, 13.4% turned positive and 3.4% died due to the disease.
The COVID-19 pandemic adversely affected the number of radiotherapy consultations and treatments at our institute. However, our department offered uninterrupted services despite grave challenges. Hypofractionated regimen was used across disease sites to minimize patient visits and allow planned treatment completion. Radiotherapy was delivered safely, and patients experienced low rates of COVID positivity during radiotherapy and even lower mortality.
在大流行期间提供癌症护理需要对标准管理进行各种更改。我们分析了 COVID-19 大流行第一波对印度塔塔纪念医院放射肿瘤治疗实践的影响。
从 2020 年 3 月 1 日至 10 月 31 日，所有连续到放射肿瘤科接受放射治疗的患者均纳入本研究。使用电子病历、患者档案和电话咨询收集患者数据，包括标准治疗方案的变化、COVID-19 检测及其结果，以及对放射治疗的后续影响。与 2019 年同期的数据进行比较，包括病例数、放疗方案、转诊率和不遵医嘱率。
我们的研究包括 4256 名中位年龄为 52 岁（四分位距 41-61 岁）的患者。新患者登记（约 63%）、放疗咨询（44.9%）和向其他中心转诊（27.8%）显著下降。与 2019 年队列相比，泌尿生殖系统病例的病例数降幅最大（-58.5%），而乳腺癌病例的降幅最小（-11.5%）。在接受根治性治疗的患者中，不遵医嘱率为 15%。所有部位均采用常规分割方案。与 2019 年相比，乳腺癌病例（-8.2 个分次）和泌尿生殖系统病例（-4.9 个分次）的患者平均每个患者的分次明显减少。在接受 COVID-19 检测的 27.8%的患者中，有 13.4%的检测结果呈阳性，有 3.4%的患者因该疾病死亡。
COVID-19 大流行严重影响了我们研究所的放疗咨询和治疗数量。然而，尽管面临严峻挑战，我们部门仍提供不间断的服务。在各个疾病部位采用了缩短分割方案，以减少患者就诊次数，并允许计划完成治疗。放射治疗安全进行，患者在放射治疗期间 COVID 阳性率较低，死亡率甚至更低。
