COVID-19 impact in radiotherapy practice in an oncology hub: a screenshot from Lombardy, Italy

Tumori. 2021 Dec;107(6):498-503. doi: 10.1177/0300891620980065. Epub 2020 Dec 16.

Abstract

Objective: During 2020, medical clinical activities were dramatically modified by the coronavirus disease 2019 (COVID-19) emergency. We aim to evaluate the impact of COVID-19 on radiotherapy (RT) practice in a hub cancer center.

Methods: Retrospective data collection of patients with suspected COVID-19 infection, identified by pathognomonic symptoms feedback at triage realized at the entrance to RT division. Inclusion criteria were diagnosis of oncologic disease, COVID-19-related symptoms, and signed written informed consent.

Results: Between 1 March and 30 June 2020, 1,006 patients accessed our RT division for RT simulation or treatment. Forty-four patients matched inclusion criteria (4.4% of all patients): 29 women and 15 men. Seventeen patients had metastatic disease. Twenty-one patients reported fever, 6 presented dyspnea, 4 complained of ageusia and anosmia, and 3 developed conjunctivitis. Thirty-six patients underwent nasal swab, with 7 positive results. From our cohort, 4 cases of pneumonia were diagnosed with computed tomography scan imaging: 3 were related to COVID-19 infection, while the fourth was evaluated as an RT adverse event. From the entire series, 4 patients died: 3 during hospitalization in intensive care unit of complications of COVID-19 and 1 of other causes neither COVID-19 nor cancer-related.

Conclusions: Cancer hub allows for safe RT practice continuation while minimizing the spread of contagion in this frail patient population. A challenge for the future will be to understand pandemic consequences in cancer natural history and manage its clinical impact.

Keywords: COVID-19; Radiotherapy; oncology hub.

MeSH terms

  • Aged
  • COVID-19 / complications
  • COVID-19 / epidemiology*
  • COVID-19 / virology
  • Disease Management
  • Female
  • Humans
  • Intensive Care Units
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / radiotherapy*
  • Neoplasms / virology
  • Practice Patterns, Physicians' / standards*
  • Radiation Oncology / standards*
  • Radiotherapy / methods*
  • Retrospective Studies
  • SARS-CoV-2 / isolation & purification*