Impact of COVID-19 on the performance of a radiation oncology department at a major comprehensive cancer centre in Poland during the first ten weeks of the epidemic.

The outbreak of SARS-CoV-2 coronavirus rapidly altered radiotherapy service delivery around the world. AIM: The main objective of this study was to assess the impact of precautionary measures implemented in response to the COVID-19 pandemic on the performance of a radiation oncology departments and on mitigation the risk of COVID-19 contagion between and among patients and staff. METHODS: The study period was from March 15 until May 22, 2020. We evaluated total number of patients irradiated and those who initiated treatments, taking into account tumours localisations. We assessed the relationship of potential risk of contagion with patients' domiciles locations in regions with high number of COVID19 case. RESULTS AND CONCLUSIONS: The number of patients treated with radiotherapy during the study period decreased due to precautionary measures. After five weeks, the number of radiotherapy treatments began to increase. Just over half of the radiotherapy patients (53.5%) treated at the GPCC reside in the city of Poznan or in one of the ten surrounding counties where COVID19 incidence was low and reached at the end of the study period cumulative number of cases n = 204. The precautionary measures were effective qRT-PCR tests were performed in 1545 individuals (patients and hospital staff) revealing four staff members and none patient with a positive PCR result. Immunoglobulin testing was performed in 1132 individuals (patients and hospital staff). A total of 63 individuals were positive for antibodies.

Method for data analysis in different institutions: example of image guidance of prostate cancer patients.

Multi-institutional collaborations allow for more information to be analyzed but the data from different sources may vary in the subgroup sizes and/or conditions of measuring. Rigorous statistical analysis is required for pooling the data in a larger set. Careful comparison of all the components of the data acquisition is indispensable: identical conditions allow for enlargement of the database with improved statistical analysis, clearly defined differences provide opportunity for establishing a better practice. The optimal sequence of required normality, asymptotic normality, and independence tests is proposed. An example of analysis of six subgroups of position corrections in three directions obtained during image guidance procedures for 216 prostate cancer patients from two institutions is presented.

Evaluation of image-guidance strategies for prostate cancer.

In this study, set-up accuracy and time consumption of different image-guidance protocols used for prostate cancer patients were compared. Set-up corrections from 60 prostate cancer patients treated on helical tomotherapy (HT) were used to simulate four types of image-guidance protocols which were based on: (i) a limited number of imaging sessions (IG-1), (ii) reduced registration tasks during daily imaging (IG-2), or (iii) and (iv) mixed methods of imaging (IG-3, IG-4). Each protocol was evaluated for three referencing scenarios based on the first fraction, first three fractions and first five fractions. Residual set-up error, the difference between the average set-up correction and the actual correction required, was used to evaluate the accuracy of each protocol. The first five fractions referencing scenario provides the highest reduction of the margins for each image-guidance protocol evaluated in this study. The first type of protocol is the shortest way to the effective correction of the systematic component of set-up error. For the second type of the protocol, the control of the residual errors is better and, as a result, the reduction of the margins is more significant than that obtained for the first one. Moreover, the second type of the protocol provides the highest accuracy of delivered dose. The result obtained for the fourth type of protocol does not decrease the calculated margins or increase their accuracy in correspondence to the no image guidance scheme. The fourth type of the protocol is not recommended as a protocol to be used to increase the conformity of the dose. The choice of the rest protocols should be validated in the context of (i) institutional practice regarding patient set-up procedure and its time consumption, (ii) acceptable balance between the amount of the dose delivered to the organ at risk and the additional imaging dose and (iii) patient anatomical conditions.