TAT. Newly diagnosed grade 1/2 xerostomia after TAT was observed in 5 patients. One patient reported no xerostomia at all. Conclusion:Our first clinical data for TAT using 225 Ac-PSMA-I&T showed promising antitumor effect in advanced mCRPC. These results are highly comparable to data on 225 Ac-PSMA-617 TAT.
Background: Telehealth services are rapidly embraced in uro-oncology due to the current coronavirus disease 2019 (COVID-19) pandemic. Objective: To determine patients' perspective on adoption of telehealth as a response to the pandemic and its sustainability in the future. Design, setting, and participants: Following a COVID-19 outbreak, 101?patients with advanced genitourinary cancers are currently managed "virtually" for therapy administration at our tertiary care unit. They were surveyed about the current situation, and current and longterm employment of telehealth. Intervention: Rapid implementation of virtual patient management. Outcome measurements and statistical analysis: Patients' perception of anxiety of COVID-19 and cancer, perspective on telehealth measures as a reaction to the current COVID-19 pandemic, and long-term acceptance were used as outcomes. Wilcoxon matched-pair signed rank test, chi-square test, and Mann-Whitney U test were performed. Results and limitations: Of 101?patients, 92?answered the questionnaire, with 71 (77.2%) responding virtually by e-mail or phone call. Anxiety of cancer (6/10, interquartile range [IQR] 3-8) superseded that of COVID-19 (four/10, IQR 2-5.25, p < 0.001), and patients oppose temporary treatment interruption. Of the patients, 66.0% perceive their susceptibility to COVID-19 as equal to or lower than the general population and 52.2% believe that COVID-19 will not affect their therapy. In future, patients (62.6%) prefer to maintain in-person appointments as opposed to complete remote care, but accept remote care during the pandemic (eight/10, IQR 5-9). Beyond the crisis, maintaining telehealth has low preference rates (four/10, IQR 2-7), with high acceptance for external laboratory controls (60.9%) and online visit management (48.9%), but lower acceptance for remote treatment planning including staging discussions (44.6%) and for referral to secondary care oncologists (17.4%). Conclusions: Despite the pandemic, cancer remains the key concern and patients are not willing to compromise on their treatment. Rapid implementation of telehealth is tolerated well during the need of social distancing, with a clear "red line" concerning changes in existing patient-physician relationships. Balancing future implementation of telehealth while considering patients' demand for personal relationships will ensure human dignity in uro-oncology. Patient summary: We queried patients with genitourinary cancers treated in an almost virtual setting following a local coronavirus outbreak. Acceptance of telehealth during the current situation is high; however, long-term implementation of the adapted services is less favored. We deduce that patient-physician relationship is crucial for cancer patients and needs to be balanced against measures for social distancing to forge the future management.
Single fraction stereotactic radiosurgery as an outpatient procedure is a treatment modality with short-term safety and efficacy. It avoids treatment related loss of renal function and hemodialysis in select patients with transitional or renal cell cancer. At short followup oncologic results were similar to those of other ablative techniques for renal tumors. To date functional results have been excellent. Further studies are needed to determine the long-term results and limits of stereotactic radiosurgery in this setting.
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