On how COVID-19 has affected radiation therapy treatments

ABSTRACT

Purpose or Objective: Cancer diagnostics and surgery have been disrupted by the response of health care services to the coronavirus disease pandemic. With the COVID-19 irruption in 2020, some radiotherapy treatments were omitted, delayed, changed intent or shifted to a hypofractionated scheme. The purpose of this study is to investigate the effect, direct or indirect, that COVID-19 has had on radiotherapy treatments in comparison with previous years. Materials and Methods: All treatments from 2018 (1521), 2019 (1498) and 2020 (1613) were analysed. Treatments were separated into two categories regarding treatment intent curative or palliative. Moreover curative treatments were classified by site or pathology H&N, lung, rectum, prostate, breast, central nervous system (CNS), gynaecological, SBRT and other sites. Percentage of hypofractionated treatments per year (for those with curative intent) was also taken into account. Results: Regarding treatment intent, we have found that the number of palliative treatments was similar to previous years 38% in 2020, 37 % in 2018 and 35% in 2019. Figure I shows the percentage of hypofractionated treatments. During 2020 there were 10% hypofractionated treatments more than 2019, which is more than a threefold increase compared to the growth between 2018 and 2019 (3%). (Figure Presented) Conclusion: On one side, reasons related directly or indirectly with COVID-19 do not had an effect on the treatment intent in our department similar number of palliative treatments was reported during 2020. On the other side, the use of hypofractionated schemes was accelerated during the pandemic, following national and international recommendations. This has allowed reducing treatment time bringing more comfort to the patients. To resume, it is difficult to assess whether the pandemic had a negative effect on cancer treatments based on treatment intent. Deeper analysis of cancer staging could reveal a different result related to collateral damage to the pandemic.