Impact of the COVID-19 Pandemic Surge on Radiation Treatment: Report From a Multicenter New York Area Institution

Abstract

PURPOSE: During the COVID-19 surge months of March and April 2020, our New York multicenter health system experienced an influx of cases with COVID-19. We sought to study the impact of the surge period on patients with cancer prescribed radiation treatment (RT). METHODS: We reviewed our secure departmental quality assurance database for all patients who underwent RT planning simulations from March 6, 2020, through April 30, 2020. A priority level between 1 and 3 was prospectively assigned to each case based on faculty consensus to determine which patients required immediate RT. In May 2020, each faculty physician again retrospectively reviewed their patients from the database and provided additional commentary on how the COVID-19 pandemic had affected each patient's care. All statistics are descriptive. RESULTS: A total of 412 RT courses in 406 unique patients were simulated for linear accelerator–based external beam RT. The median age was 66 years. Treatment intent was curative in 70.6% and palliative in 29.4%. Of the 412 cases, 66.7% were priority 1, 25% priority 2, and 7.8% priority 3. Two hundred thirty-nine cases (58%) underwent standard-of-care diagnosis, workup, and treatment plan. Seventeen patients (4.1%) electively canceled their RT, and 17 others (4.1%) electively delayed RT start. Thirty-four (8.3%) were prescribed hypofractionation to shorten their RT course, and 22 (5.3%) had a change in modality. Incomplete or delayed workup was identified in 19 cases (4.6%). CONCLUSION: The COVID-19 pandemic surge resulted in 42% of our patients having a non–standard-of-care pathway. This outcome demonstrates a significant impact of the COVID-19 crisis on routine cancer care.

Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

“…Regarding radiotherapy treatments, 57 indicators from 8 articles [55,90,92,121,135–138] were identified. Most of these indicators signalled a reduction of the number of treatments (n=41, 72%), namely in UK, US, and Canada.…”

“…Sixteen indicators (38%) signalled stable waiting times and 8 (19%) a reduction in time to treatment. Twenty-one surveys [58,70,84–86,88,108,109,114,117,132–134,141,147–153], 2 studies using administrative data and surveys [121, 138] and 1 prospective study [117] reported on delays in cancer treatment. From those, eleven articles were international studies.…”

“…Twenty-one surveys [58,70,[84][85][86]88,108,109,114,117,[132][133][134]141,[147][148][149][150][151][152][153], 2 studies using administrative data and surveys [121,138] and 1 prospective study [117] reported on delays in cancer treatment. From those, eleven articles were international studies.…”

“…Fifty articles reported on "changes in treatment", resulting in 304 indicators collated. A total of 106 indicators (19 articles [50,52,65,75,77,90,[96][97][98]101,102,106,118,121,135,137,138,142,154]) were collected from administrative data, 13 indicators from registry data [134,138] and 185 were surveybase information [13,46,58,70,78,85,88,[113][114][115][116]126,130,141,145,[148][149][150][151][155][156][157][158][159]. Changes in treatment are summarized in Fig.…”

Telehealth in Multidisciplinary Target Delineation for Radiotherapy During the COVID-19 Pandemic. A Review and a Case

“…Furthermore, the patients are at a greater risk of serious complications from a COVID-19 infection, largely due to comorbidities ( 1 ), and recent treatment may be a risk factor for a severe course of COVID-19 ( 2 , 3 ). Due to staffing challenges and risk of disease transmissions, radiotherapy treatments have been postponed, interrupted, shortened using hypo-fractionation or even cancelled ( [4] , [5] , [6] , [7] , [8] , [9] ). The impact of the pandemic, of course, depending on the regional effect of the pandemic.…”