Time to initiation of radiation therapy during the COVID-19 pandemic

ABSTRACT

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has dramatically affected the care of head and neck cancer (HNC) patients. Given the reallocation of health care resources and focus on minimizing the risk of novel coronavirus transmission, concerns about delays in care for nonemergent conditions have been raised. Delays in presentation, diagnosis, and initiation of treatment in HNC patients have been associated with disease progression and adverse oncologic outcomes. We aim to quantify times to initiation of radiation therapy in patients with HNC during the COVID-19 pandemic. Method: This single-institution retrospective study included 146 patients (103 pre- and 43 during COVID-19) 18 years and older diagnosed with HNC whose treatment included radiation therapy. Patients were included in the pre-COVID-19 group if treatment recommendations were made from January 1, 2019, to March 20, 2020. Patients were included in the during-COVID-19 group if treatment recommendations were made from March 21, 2020, to December 12, 2020. Multivariable linear regressions were used to examine the association between the 2 COVID-19 treatment groups and times to initiation of radiation therapy, adjusting for age, gender, marital status, and insurance. Results: The average times to initiation of radiation therapy were shorter for the during-COVID-19 period than the pre- COVID-19 period. In the adjusted analyses, there were no significant differences between the pre- and during-COVID-19 groups with respect to time from presentation to otolaryngology (P = .3975), presentation to a health care provider (P = .6237), biopsy (P = .1973), pathology date (P = .0881), imaging (P = .4564), and tumor board (P = .2466) to initiation of radiation therapy. Conclusion: No significant difference in times to initiation of radiation therapy was found between pre-COVID-19 and during-COVID-19 groups. Radiation therapy continues to be a viable treatment modality for head and neck patients during the COVID-19 pandemic and can be administered without delays in care.