Adapting palliative radiation therapy for bone metastases during the Covid-19 pandemic: GEMO position paper

Sébastien Thureau; Jean Christophe Faivre; Richard Assaker; Emmanuel Biver; Cyrille B Confavreux; Françoise Debiais; Martine Duterque-Coquillaud; Francesco Giammarile; Dominique Heymann; Frédéric E Lecouvet; Laetitia Morardet; Frederic Paycha; Jean-Jacques Body; Marie-Hélène Vieillard

doi:10.1016/j.jbo.2020.100291

Adapting palliative radiation therapy for bone metastases during the Covid-19 pandemic: GEMO position paper

J Bone Oncol. 2020 Apr 13:22:100291. doi: 10.1016/j.jbo.2020.100291. eCollection 2020 Jun.

Authors

Affiliations

¹ Radiation department, Center Henri Becquerel, Quantif-Litis EA 4108, University of Rouen, Rouen, France.
² Radiation department, Institut de Cancérologie de Lorraine - Alexis-Vautrin, Vandœuvre-lès-Nancy, France.
³ University Department of neurosurgery, Lille University Hospital, Lille, France.
⁴ Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
⁵ INSERM UMR 1033 - University of Lyon, Bone Metastasis Expert Center (CEMOS) Cancer Institute of Hospices Civils de Lyon, Rheumatology Department, Centre Hospitalier Lyon Sud, Pierre Bénite, F- 69310 France.
⁶ Rheumatology department, CHU Poitiers, Poitiers, France.
⁷ CNRS UMR9020, INSERM UMR1277, University of Lille, Institut Pasteur de Lille, CHU Lille, France.
⁸ Nuclear Medecine LUMEN, Centre Leon Berard, Lyon, France.
⁹ Institut de Cancérologie de l'Ouest, University of Nantes, Inserm, CRCINA, Saint-Herblain, France.
¹⁰ Institut du Cancer Roi Albert 2, Cliniques Universitaires Saint-Luc, Service de Radiologie et d'Imagerie Médicale, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium.
¹¹ Oncology Department, Pitié Salpêtrière Hospital, Paris, France.
¹² Nuclear Medicine Department, Lariboisière University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
¹³ Department of Medicine, CHU Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium.
¹⁴ University department of Rheumatology, Lille University hospital; Oscar Lambret Center; CNRS UMR9020, INSERM UMR1277, University of Lille, Institut Pasteur, Lille.

Abstract

The current health crisis caused by COVID-19 is a challenge for oncology treatment, especially when it comes to radiotherapy. Cancer patients are already known to be very fragile and COVID-19 brings about the risk of severe respiratory complications. In order to treat patients safely while protecting medical teams, the entire health care system must optimize the way it approaches prevention and treatment at a time when social distancing is key to stemming this pandemic. All indications and treatment modalities must be re-discussed. This is particularly the case for radiotherapy of bone metastases for which it is possible to reduce the number of sessions, the frequency of transport and the complexity of treatments. These changes will have to be discussed according to the organization of each radiotherapy department and the health situation, while medical teams must remain vigilant about the risks of complications of bone metastases, particularly spinal metastases. In this short piece, the members of the GEMO (the European Study Group of Bone Metastases) offer a number of recommendations to achieve the above objectives, both in general and in relation to five of the most common situations on radiation therapy for bone metastases.