Division of Hematology and Oncology, Dartmouth Cancer Center, Dartmouth Health, Geisel School of Medicine at Dartmouth, Lebanon, NH.
Division of Radiation Oncology, Liga Contra El Cáncer, San Pedro Sula, Honduras.
JCO Glob Oncol. 2024 Aug;10:e2400051. doi: 10.1200/GO.24.00051.
This study aimed to identify, evaluate, and rank suitable safety innovations developed during the COVID-19 pandemic in Latin American and Caribbean (LAC) radiation oncology centers.
We conducted a multimodal participatory engagement collaboration with the Latin-American and Caribbean Society of Medical Oncology. The study consisted of four phases. Innovations were collected from a panel of radiotherapy experts representing a diverse group of 11 countries from LAC (Phase I). Next, a medical scientific team compared the innovations against international standards regarding their potential impact on risk of infection, clinical operation, and continuity of quality cancer care (Phase II). Their findings were supplied to the country representatives who rated the innovations for acceptability in their cancer centers (Phase III), resulting in a final report of the panel's recommendations (Phase IV).
A total of 81 innovations were reported by the country representatives and merged by the medical scientific team into 24 innovations that combined similar innovations. The 24 innovations were grouped into six categories including practices aimed at (1) reducing clinic crowding (n = 3), (2) increasing screening and vaccinations for COVID-19 disease (n = 5), (3) implementing social distancing (n = 6), (4) strengthening personal infection equipment and disinfection (n = 6), (5) avoiding delaying or shortening treatment protocols (n = 2), and (6) mixed procedures (n = 2). The medical scientific team found nearly all innovations were supported by international recommendations and rated as safe, efficient, and acceptable.
By using the lessons learned from the Community-Led Action Research in Oncology: Pandemic-Appropriate Radiotherapy Innovations Evaluated study, a manual of scalable practices in radiation oncology clinics may be developed to guide actions during future large-scale public health crises in low- and middle-income countries of LAC.
本研究旨在识别、评估和对拉丁美洲和加勒比地区（LAC）放射肿瘤学中心在 COVID-19 大流行期间开发的安全创新进行排名。
我们与拉丁美洲和加勒比医学肿瘤学会进行了多模式参与式合作。该研究包括四个阶段。创新是由代表来自 LAC 的 11 个国家的多样化小组的放射治疗专家小组收集的（第一阶段）。接下来，一个医学科学团队将这些创新与国际标准进行比较，以评估其对感染风险、临床操作和癌症护理质量连续性的潜在影响（第二阶段）。他们的发现提供给国家代表，由他们对其癌症中心的创新进行可接受性评估（第三阶段），从而得出小组建议的最终报告（第四阶段）。
国家代表共报告了 81 项创新，医学科学团队将这些创新合并为 24 项创新，这些创新合并了类似的创新。这 24 项创新分为六个类别，包括旨在（1）减少诊所拥挤的措施（n = 3）、（2）增加 COVID-19 疾病的筛查和疫苗接种（n = 5）、（3）实施社会距离（n = 6）、（4）加强个人感染设备和消毒（n = 6）、（5）避免延迟或缩短治疗方案（n = 2）和（6）混合程序（n = 2）。医学科学团队发现几乎所有的创新都得到了国际建议的支持，并被评为安全、高效和可接受的。
通过利用社区主导的肿瘤学行动研究：评估适合大流行的放射治疗创新研究中的经验教训，可能会开发出一份放射肿瘤学诊所可扩展实践手册，以指导中低收入国家在未来的大规模公共卫生危机期间采取行动。
