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Mini Oral session 1

203MO - Changes in management for patients with lung cancer treated with radical radiotherapy during the first wave of the COVID-19 pandemic in the UK (COVID-RT Lung)

Date

26 Mar 2021

Session

Mini Oral session 1

Presenters

Kathryn Banfill

Citation

Journal of Thoracic Oncology (2021) 16 (suppl_4): S807-S814.

Authors

K. Banfill1, G. Price2, K. Wicks2, A. Britten3, C. Carson4, M. Hatton5, K. Thippu Jayaprakash6, A. Jegannathen7, C.L. Lee8, N. Panakis9, C. Peedell10, C. Stilwell11, T. Pope12, C. Powell13, V. Wood14, S. Zhou15, C. Faivre-Finn16

Author affiliations

  • 1 Cancer Research UK Manchester Institute, M20 4BX - Manchester/GB
  • 2 Manchester Cancer Research Centre, Manchester/GB
  • 3 Oncology, Royal Sussex County Hospital - Brighton and Sussex University Hospitals NHS Trust, BN2 5BE - Brighton/GB
  • 4 Northern Ireland Cancer Centre, Belfast/GB
  • 5 Weston Park Hospital, Sheffield/GB
  • 6 Addenbrooke's Hospital - Cambridge University Hospitals NHS Foundation Trust, CB2 0QQ - Cambridge/GB
  • 7 University Hospitals of North Midlands, Stoke on Trent/GB
  • 8 New Cross Hospital, Wolverhampton/GB
  • 9 Oxford University Hospitals, Oxford/GB
  • 10 South Tees NHS Foundation Trust, Middlesbrough/GB
  • 11 Aberdeen/GB
  • 12 The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool/GB
  • 13 Velindre Cancer Centre, Cardiff/GB
  • 14 University Hospital Southampton NHS Foundation Trust, Southampton/GB
  • 15 Beatson West of Scotland Cancer Centre, Glasgow/GB
  • 16 The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
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Resources

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Abstract 203MO

Background

In response to the COVID-19 pandemic, guidelines on reduced fractionation for patients with lung cancer treated with curative-intent radiotherapy (RT) were published (Faivre-Finn et al) aiming to reduce the number of hospital attendances and potential exposure of vulnerable patients to SARS-CoV-2. Here we describe the changes that have taken place.

Methods

COVID-RT Lung is a prospective multicentre UK data collection. Inclusion criteria are: patients with stage 1–3 lung cancer (biopsy-proven or diagnosed on cross-sectional imaging) referred for and/or treated with radical RT between 2/4/2020–2/10/2020. Both patients who had a change in their management and those who continue with standard management are included. Data on demographics, COVID-19 diagnosis, diagnostic work-up, RT and systemic treatment, treatment-related toxicity, disease/patient status are collected. Each participating centre obtains local approval and anonymised data is collected on a central, cloud-based Research Electronic Data Capture system.

Results

1117 records from 20 UK RT sites were available for analysis on 30/11/2020. 562 (50%) female, median age 72 years (38–93 years). 15 patients (1%) were diagnosed with COVID-19, 9 prior to treatment. 160 patients (14%) had their diagnostic investigations affected by the pandemic. 415 patients (37%) had their treatment changed from their centre's standard of care (table). Patients with PS0-1 were more likely to have their treatment changed compared to patients with a poorer PS. The median number of RT fractions was 15 for patients who had their RT dose/fractionation changed compared to 20 for those who were treated as per standard of care.

Table 203MO:

Changes to management of patients treated for stage 1–3 lung cancer during the COVID-19 pandemic

Change in managementPatients
Different RT dose/fractionation210
RT instead of surgery86
Chemotherapy omitted87
Chemotherapy reduced56
Watch and wait24
No treatment3
Immunotherapy omitted/reduced6
PCI omitted4

Conclusions

This nationwide cohort shows that clinicians in the UK changed the management of patients with stage 1–3 lung cancer in line with national guidelines. The main changes are a reduction in chemotherapy use and an increase in RT hypofractionation.

Legal entity responsible for the study

University of Manchester.

Funding

Biomedical Research Centre, Manchester.

Disclosure

K. Thippu Jayaprakash: Travel/Accommodation/Expenses: Bayer UK; Travel/Accommodation/Expenses: Janssen Oncology; Travel/Accommodation/Expenses: Pfizer; Travel/Accommodation/Expenses: Roche; Travel/Accommodation/Expenses: Takeda; Research grant/Funding (self): UK National Institute of Health Research Clinical Research Network Eastern.

C. Peedell: Speaker Bureau/Expert testimony: Elekta; Speaker Bureau/Expert testimony: Boston Scientific; Speaker Bureau/Expert testimony: AstraZeneca.

C. Faivre-Finn: Research grant/Funding (institution): Elekta. All other authors have declared no conflicts of interest.

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