Navigating the challenges of the COVID-19 outbreak: Perspectives from the radiation oncology service in Singapore

Tey, Jeremy; Ho, S.; Choo, Bok Ai; Ho, Francis; Yap, Swee Peng; Tuan, Jeffrey Kit Loong; Leong, Cheng Nang; Cheo, Timothy; Sommat, Kiattisa; Wang, Michael L.C.

doi:10.1016/j.radonc.2020.03.030

Cited by 42 publications

(68 citation statements)

References 6 publications

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“…This, combined with the considerable rate of transmission from asymptomatic subjects [33] and the incubation time [34], could justify the high incidence of infection in the initial two weeks. The strict application of a dedicated work ow and the constant adoption of adequate PPE [35][36] allowed us not only to contain and almost neutralize the diffusion of the infection, but also to carry on radiation therapy in patients positive for SARS-Cov-2 with mild or asymptomatic disease. The infection rate among patients undergoing treatment at our department outstandingly precipitated to 0.43% considering the period from March 25 to April 24 and no new contagion among our staff was observed in this time span.…”

Section: Covid-19 Impact On the Staffmentioning

confidence: 99%

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

Buglione

Spiazzi

Guerini

et al. 2020

Preprint

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Abstract Background: Coronavirus Disease 2019 (COVID-19) pandemic had an overwhelming impact on healthcare worldwide. Outstandingly, the aftermath on neoplastic patients is still largely unknown, and only isolated cases of COVID-19 during radiotherapy have been published. We will report the two-months experience of our Department, set in Lombardy “red-zone”.Methods: data of 402 cancer patients undergoing active treatment from February 24 to April 24, 2020 were retrospectively reviewed; several indicators of the Department functioning were also analyzed.Results: dedicated measures allowed an overall limited reduction of the workload. Decrease of radiotherapy treatment number reached 17%, while the number of administration of systemic treatment and follow up evaluations kept constant. Conversely, new treatment planning faced substantial decline. Considering the patients, infection rate was 3.23% (13/402) and mortality 1.24% (5/402). Median age of COVID-19 patients was 69.7 years, the large majority were male and smokers (84.6%); lung cancer was the most common tumor type (61.5%), 84.6% of subjects were stage III-IV and 92.3% had comorbidities. Remarkably, 92.3% of the cases were detected before March 24. Globally, only 2.5% of ongoing treatments were suspended due to suspect or confirmed COVID-19 and 46.2% of positive patients carried on radiotherapy without interruption. Considering only the last month, infection rate among patients undergoing treatment precipitated to 0.43% (1/232) and no new contagions were reported within our staff. Conclusions: although mortality rate in COVID-19 cancer patients is elevated, our results support the feasibility and safety of continuing anticancer treatment during SARS-Cov-2 pandemic by endorsing consistent preventive measures.

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Section: Covid-19 Impact On the Staffmentioning

confidence: 99%

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

Buglione

Spiazzi

Guerini

et al. 2020

Preprint

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“…To add to these challenges, patients with HNC are generally elderly and have significant comorbidity, which increases their risk of COVID‐19‐related death if they contract the infection. In addition, treatment for HNC itself, including surgery, radiation, and systemic therapy, may reduce the patient's ability to combat a COVID‐19 infection, and given the limited available data, the increased risk of COVID‐19‐related mortality in patients with cancer is still not completely known 8‐12 …”

Section: Head and Neck Cancermentioning

confidence: 99%

“…Head and neck radiation may be associated with severe mucositis, poor oral intake, weight loss, dehydration, and fatigue, all of which have yet unknown impact on the risk for patients contracting COVID‐19 or developing a more severe disease if they get infected. Radiation therapy also requires daily treatment for a period of 6 weeks, which is challenging for most patients in terms of logistics at a time when stay‐home orders are getting more widespread, quarantine requirements are in effect when crossing state lines, and patients' family members and caregivers are increasingly restricted from accessing the hospitals to accompany patients during their treatment visits 11,12 …”

Section: Does Routine Testing Of Asymptomatic Patients Help?mentioning

confidence: 99%

How fragile we are

Hanna

2020

Head & Neck

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Section: Covid-19 Impact On the Staffmentioning

confidence: 99%

Two Months of Radiation Oncology in the Heart of Italian “Red Zone” During COVID-19 Pandemic: Paving A Safe Path Over Thin Ice.

Buglione

Spiazzi

Guerini

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Coronavirus Disease 2019 (COVID-19) pandemic had an overwhelming impact on healthcare worldwide. Outstandingly, the aftermath on neoplastic patients is still largely unknown, and only isolated cases of COVID-19 during radiotherapy have been published. We will report the two-months experience of our Department, set in Lombardy “red-zone”.Methods: data of 402 cancer patients undergoing active treatment from February 24 to April 24, 2020 were retrospectively reviewed; several indicators of the Department functioning were also analyzed.Results: dedicated measures allowed an overall limited reduction of the workload. Decrease of radiotherapy treatment number reached 17%, while the number of administration of systemic treatment and follow up evaluations kept constant. Conversely, new treatment planning faced substantial decline. Considering the patients, infection rate was 3.23% (13/402) and mortality 1.24% (5/402). Median age of COVID-19 patients was 69.7 years, the large majority were male and smokers (84.6%); lung cancer was the most common tumor type (61.5%), 84.6% of subjects were stage III-IV and 92.3% had comorbidities. Remarkably, 92.3% of the cases were detected before March 24. Globally, only 2.5% of ongoing treatments were suspended due to suspect or confirmed COVID-19 and 46.2% of positive patients carried on radiotherapy without interruption. Considering only the last month, infection rate among patients undergoing treatment precipitated to 0.43% (1/232) and no new contagions were reported within our staff. Conclusions: although mortality rate in COVID-19 cancer patients is elevated, our results support the feasibility and safety of continuing anticancer treatment during SARS-Cov-2 pandemic by endorsing consistent preventive measures.

show abstract

Navigating the challenges of the COVID-19 outbreak: Perspectives from the radiation oncology service in Singapore

Cited by 42 publications

References 6 publications

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

How fragile we are

Two Months of Radiation Oncology in the Heart of Italian “Red Zone” During COVID-19 Pandemic: Paving A Safe Path Over Thin Ice.

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