Impact of COVID-19 on workload burden of a complex radiotherapy facility

Desideri, Isacco; Stocchi, G.; Ciccone, L.P.; Salvestrini, Viola; Garlatti, Pietro; Aquilano, M.; Greto, Daniela; Bonomo, Pierluigi; Meattini, Icro; Scotti, Vieri; Scoccianti, Silvia; Simontacchi, Gabriele; Livi, Lorenzo

doi:10.1007/s11547-021-01338-8

Cited by 20 publications

(11 citation statements)

References 19 publications

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“…These findings seem to suggest that SSRT may be considered a valid alternative for post-prostatectomy macroscopic local recurrence, offering short (convenient), cost-effective, well-tolerated and efficacious approach. Interestingly, shorter treatment schedule may be particularly useful during the COVID-19 pandemic [ 25 , 26 ]. Moreover, SSRT may offer a valid approach to implement information offered by new imaging modalities (e.g.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic or conventional radiotherapy for macroscopic prostate bed recurrence: a propensity score analysis

et al. 2022

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Purpose To assess outcomes between salvage radiation therapy (SRT) with curative intent and stereotactic radiotherapy for macroscopic prostate recurrence (SSRT) after radical prostatectomy (RP). In order to compare these two different options, we compared their outcomes with a propensity score-based matched analysis. Methods Data from 185 patients in seven Italian centres treated for macroscopic prostate bed recurrence after RP were retrospectively collected. To make a comparison between the two treatment groups, propensity matching was applied to create comparable cohorts. Results After matching, 90 patients in the SRT and SSRT groups were selected (45 in each arm). Kaplan–Meier analysis did not show any significant differences in terms of BRFS and PFS between matched populations ( p = 0.08 and p = 0.8, respectively). Multivariate models show that treatment was not associated with BRFS, neither in the whole or matched cohort, with HR of 2.15 (95%CI 0.63–7.25, p = 0.21) and 2.65 (95%CI 0.59–11.97, p = 0.21), respectively. In the matched cohort, lower rate of toxicity was confirmed for patients undergoing SSRT, with acute GI and GU adverse events reported in 4.4 versus 44.4% ( p < 0.001) and 28.9 versus 46.7% ( p = 0.08) of patients, and late GI and GU adverse events reported in 0 versus 13.3% ( p = 0.04) and 6.7 versus 22.2% ( p = 0.03) of patients, respectively. Conclusion Considering the favourable therapeutic ratio of this approach and the lower number of fractions needed, SSRT should be considered as an attractive alternative to conventional SRT in this setting. Supplementary Information The online version contains supplementary material available at 10.1007/s11547-022-01465-w.

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Section: Discussionmentioning

confidence: 99%

Stereotactic or conventional radiotherapy for macroscopic prostate bed recurrence: a propensity score analysis

et al. 2022

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“…As to the “gravity assessment” of COVID-19 infection and evaluation of pulmonary parenchymal involvement, several scores have been proposed [ 62 , 63 ]. The main goal of these tools is to establish a well-defined strategy for evaluation of the airways and lungs of COVID-19 positive patients from Computed Tomography (CT) scans, including detected abnormalities [ 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ]. Their identification and the volumetric quantification may allow an easier classification in terms of gravity, extent and progression of the disease.…”

Section: Introductionmentioning

confidence: 99%

Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center

Granata

Fusco

Villanacci

et al. 2022

JPM

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Purpose: To analyze the vaccine effect by comparing five groups: unvaccinated patients with Alpha variant, unvaccinated patients with Delta variant, vaccinated patients with Delta variant, unvaccinated patients with Omicron variant, and vaccinated patients with Omicron variant, assessing the “gravity” of COVID-19 pulmonary involvement, based on CT findings in critically ill patients admitted to Intensive Care Unit (ICU). Methods: Patients were selected by ICU database considering the period from December 2021 to 23 March 2022, according to the following inclusion criteria: patients with proven Omicron variant COVID-19 infection with known COVID-19 vaccination with at least two doses and with chest Computed Tomography (CT) study during ICU hospitalization. Wee also evaluated the ICU database considering the period from March 2020 to December 2021, to select unvaccinated consecutive patients with Alpha variant, subjected to CT study, consecutive unvaccinated and vaccinated patients with Delta variant, subjected to CT study, and, consecutive unvaccinated patients with Omicron variant, subjected to CT study. CT images were evaluated qualitatively using a severity score scale of 5 levels (none involvement, mild: ≤25% of involvement, moderate: 26–50% of involvement, severe: 51–75% of involvement, and critical involvement: 76–100%) and quantitatively, using the Philips IntelliSpace Portal clinical application CT COPD computer tool. For each patient the lung volumetry was performed identifying the percentage value of aerated residual lung volume. Non-parametric tests for continuous and categorical variables were performed to assess statistically significant differences among groups. Results: The patient study group was composed of 13 vaccinated patients affected by the Omicron variant (Omicron V). As control groups we identified: 20 unvaccinated patients with Alpha variant (Alpha NV); 20 unvaccinated patients with Delta variant (Delta NV); 18 vaccinated patients with Delta variant (Delta V); and 20 unvaccinated patients affected by the Omicron variant (Omicron NV). No differences between the groups under examination were found (p value > 0.05 at Chi square test) in terms of risk factors (age, cardiovascular diseases, diabetes, immunosuppression, chronic kidney, cardiac, pulmonary, neurologic, and liver disease, etc.). A different median value of aerated residual lung volume was observed in the Delta variant groups: median value of aerated residual lung volume was 46.70% in unvaccinated patients compared to 67.10% in vaccinated patients. In addition, in patients with Delta variant every other extracted volume by automatic tool showed a statistically significant difference between vaccinated and unvaccinated group. Statistically significant differences were observed for each extracted volume by automatic tool between unvaccinated patients affected by Alpha variant and vaccinated patients affected by Delta variant of COVID-19. Good statistically significant correlations among volumes extracted by automatic tool for each lung lobe and overall radiological severity score were obtained (ICC range 0.71–0.86). GGO was the main sign of COVID-19 lesions on CT images found in 87 of the 91 (95.6%) patients. No statistically significant differences were observed in CT findings (ground glass opacities (GGO), consolidation or crazy paving sign) among patient groups. Conclusion: In our study, we showed that in critically ill patients no difference were observed in terms of severity of disease or exitus, between unvaccinated and vaccinated patients. The only statistically significant differences were observed, with regard to the severity of COVID-19 pulmonary parenchymal involvement, between unvaccinated patients affected by Alpha variant and vaccinated patients affected by Delta variant, and between unvaccinated patients with Delta variant and vaccinated patients with Delta variant.

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“…In terms of organizational well-being, the high score reported for each ITEM showed that the organizational changes during COVID-19 period were well tolerated due to the knowledge of their utility in terms of patients and personal security. Another analysis, despite without the use of an organizational well-being questionnaire, showed the same results; in fact, Francolini et al showed that organizational changes during pandemic did not significantly affect normal radiotherapy workflow in selected situations [ 24 ].…”

Section: Discussionmentioning

confidence: 75%

Impact on mental health of the COVID-19 pandemic in a radiation oncology department

et al. 2022

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Aim To evaluate the emotional state and organizational well-being of healthcare workers in radiation oncology departments, during the COVID pandemic. Methods A survey was carried out with three questionnaires: Impact of Event Scale—Revised (IES-R); Italian ANAC questionnaire; and Maslach Burnout Inventory (MBI). Comparisons between groups were done by Student’s t test. Results Seventy-eight questionnaires for 26 workers were analyzed. Thirty-three percent of the sample obtained an IES-R high score, such as post-traumatic syndrome. In terms of organizational well-being, younger age and lower working seniority were statistically significant for higher score of ANAC items ( p < 0.5). Regarding MBI, 0, 27 and 50% high scores of emotional exhaustion, depersonalization and personal accomplishment were reported, respectively. Low working seniority and male sex were correlated with high score of personal accomplishment ( p :0.05; p :0.03). Conclusion Intervention to promote mental health well-being should be implemented in radiation oncology department.

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Impact of COVID-19 on workload burden of a complex radiotherapy facility

Cited by 20 publications

References 19 publications

Stereotactic or conventional radiotherapy for macroscopic prostate bed recurrence: a propensity score analysis

Stereotactic or conventional radiotherapy for macroscopic prostate bed recurrence: a propensity score analysis

Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center

Impact on mental health of the COVID-19 pandemic in a radiation oncology department

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