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Cancer Rep (Hoboken) ; 4(2): e1320, 2021 04.
Article in English | MEDLINE | ID: covidwho-967725

ABSTRACT

BACKGROUND: COVID-19 outbreak was declared as a pandemic by the World Health Organization in March 2020. Over the last 3 months, the pandemic has challenged the diagnosis and treatment of all cancer, including rectal cancer. Constraints in resources call for a change in the treatment strategy without compromising efficacy. RECENT FINDINGS: Delivery of shorter treatment schedules for radiotherapy offers advantages like short overall treatment time, improved throughput on the machine, improved compliance and reduced risk of transmission of COVID 19. Other strategies include delaying surgery, reducing the intensity of chemotherapy and adoption of organ preservation approach. CONCLUSION: The curative treatment of rectal cancer should not be hindered during the COVID pandemic, and modifications in the multi-modality treatment will help achieve quality care.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/standards , Pandemics/prevention & control , Radiation Oncology/organization & administration , Rectal Neoplasms/therapy , COVID-19/epidemiology , COVID-19/transmission , Chemoradiotherapy, Adjuvant/methods , Chemoradiotherapy, Adjuvant/standards , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Neoadjuvant Therapy/methods , Neoadjuvant Therapy/standards , Organ Sparing Treatments/methods , Organ Sparing Treatments/standards , Personal Protective Equipment/standards , Radiation Oncology/methods , Radiation Oncology/standards , Radiotherapy, Adjuvant/methods , Radiotherapy, Adjuvant/standards , Rectal Neoplasms/diagnosis , Telemedicine/methods , Telemedicine/organization & administration , Telemedicine/standards , Time Factors , Time-to-Treatment/standards , Treatment Outcome
2.
Clin Genitourin Cancer ; 19(1): 41-46.e1, 2021 02.
Article in English | MEDLINE | ID: covidwho-926856

ABSTRACT

INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic, providers and patients must engage in shared decision making to ensure that the benefit of early intervention for muscle-invasive bladder cancer exceeds the risk of contracting COVID-19 in the clinical setting. It is unknown whether treatment delays for patients eligible for curative chemoradiation (CRT) compromise long-term outcomes. PATIENTS AND METHODS: We used the National Cancer Data Base to investigate whether there is an association between a ≥ 90-day delay from transurethral resection of bladder tumor (TURBT) in initiating CRT and overall survival. We included patients with cT2-4N0M0 muscle-invasive bladder cancer from 2004 to 2015 who underwent TURBT and curative-intent concurrent CRT. Patients were grouped on the basis of timing of CRT: ≤ 89 days after TURBT (earlier) vs. ≥ 90 and < 180 days after TURBT (delayed). RESULTS: A total of 1387 (87.5%) received earlier CRT (median, 45 days after TURBT; interquartile range, 34-59 days), and 197 (12.5%) received delayed CRT (median, 111 days after TURBT; interquartile range, 98-130 days). Median overall survival was 29.0 months (95% CI, 26.0-32.0) versus 27.0 months (95% CI, 19.75-34.24) for earlier and delayed CRT (P = .94). On multivariable analysis, delayed CRT was not associated with an overall survival difference (hazard ratio, 1.05; 95% CI, 0.87-1.27; P = .60). CONCLUSION: Although these results are limited and require validation, short, strategic treatment delays during a pandemic can be considered on the basis of clinician judgment.


Subject(s)
COVID-19/prevention & control , Chemoradiotherapy, Adjuvant/standards , Decision Making, Shared , Time-to-Treatment/standards , Urinary Bladder Neoplasms/therapy , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/transmission , Chemoradiotherapy, Adjuvant/statistics & numerical data , Cystectomy , Female , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Neoplasm Invasiveness , Pandemics/prevention & control , Time Factors , Time-to-Treatment/statistics & numerical data , Treatment Outcome , Urinary Bladder Neoplasms/mortality , Urinary Bladder Neoplasms/pathology , Young Adult
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