Prospective planning of radiationtreatment at new patient conference during the COVID-19Pandemic: The University of Mississippi Medical Centerexperience

ABSTRACT

Objective: To evaluate patterns of patient management in an academic Radiation Oncology department between3/17/20 and 5/8/20 during the COVID-19 pandemic. Background: As a response to the worldwide COVID-19 pandemic, our Radiation Oncology department instituted anumber of measures to limit spread of the disease to our patients and staff. This included prospectively evaluatingall new referrals for radiation treatment and determining an appropriate course of action, which if appropriateincluded delaying the start of radiation, hypofractionation, or using other modalities of treatment prior to start ofradiation. Methods: We analyzed data for 82 patients between 3/17/20-5/8/20 to evaluate patterns of management. The chi-squared test was used to evaluate the descriptive characteristics of the study population, with P values ≤ 0.05considered statistically significant. One sample t-test was used to compare the statistical mean difference betweensample variables. Data were analyzed using SPSS 24.0 software (IBM, Armonk, NY, USA). Results: The data set comprised 38% Caucasians and 59% African Americans. An age breakdown revealed 12.3%below age 30, 42% between ages 30-60, and 45.7% over age of 60. When the data were analyzed by gender, wenoted a significant difference by site of treatment (p=0.005) and whether immediate treatment was required or not(p=0.029). This likely reflects gender-driven differences in cancer site with patients diagnosed with prostate cancergetting LHRH agonist therapy prior to start of radiation. Hypofractionated radiation schedules were used in 2patients with cord compression early during the study period compared to 3 patients who received standardfractionation later, and one person elected to go straight to hospice care (p=0.002). Of patients for heterotopicossification prophylaxis, 3/14 declined radiation and one was over the weight limit of the radiation table (p=0.000).41% of patients were inpatients. No patients developed COVID-19 during our study period. Conclusion: A prospective evaluation of new patient referrals may have helped mitigate the spread of COVID-19 atour Radiation Oncology facility. This is one of several prospective measures that our department took to protectpatients and staff.