Radiotherapy Delays Due To COVID-19 Reported

Author: By Shreeya Nanda, Senior medwireNews Reporter

medwireNews: A substantial proportion of patients with cancer have experienced disruptions to their radiotherapy schedules during the COVID-19 pandemic, report researchers in a letter to JAMA Oncology.

They explain that public health measures – such as city lockdown, traffic restrictions and social distancing – have been “effective in limiting virus transmission and reducing daily new COVID-19 cases across all age groups” in Wuhan in China.

“However, there are concerns that these public health measures will affect the delivery of other health care services”, comment Conghua Xie, from Zhongnan Hospital of Wuhan University, and colleagues.

The team therefore analysed the records of 209 patients (49.8% men) aged a median of 55 years who had radiotherapy, either alone or alongside chemotherapy, scheduled between 20 January and 5 March 2020. All individuals had commenced treatment prior to the start date of the study.

Thoracic cancers, namely lung, breast and oesophageal, were most common, at 38.3%, followed by gastrointestinal or gynaecological cancers (25.8%) and head and neck cancers (25.4%). Just under half (47.4%) were receiving adjuvant radiotherapy, while 27.3% and 25.3% were receiving radical and palliative radiotherapy, respectively.

Around half (53.6%) of the patients were unable to continue radiotherapy after the city lockdown was initiated on 23 January, primarily as they could not return to Wuhan after “the massive human migration (Chunyun) for the Spring Festival that preceded the lockdown”, report the study authors.

Of the 67 patients receiving chemoradiotherapy, 92.5% (n=62) stopped treatment. Once again the reason for discontinuation in the majority (n=58) of cases was the inability to return to the hospital, although in four cases treatment was discontinued by physician’s choice. Just two patients continued chemoradiotherapy after lockdown and three completed treatment.

Additionally, there was a large drop in the average number of radiotherapy sessions at the hospital once lockdown was initiated, from 188 per day before lockdown to 12 per day after.

Only one of the study participants was diagnosed with SARS-CoV-2 during the study period and none of the 70 patients who had a history of contact with the patient developed COVID-19 symptoms, say Conghua Xie and team.

And they conclude: “Long-term follow-up data may reveal detrimental ramifications of treatment interruption on the survival of these patients with cancer.”

Reference

Xie C, Wang X, Liu H, et al. Outcomes in radiotherapy-treated patients with cancer during the COVID-19 outbreak in Wuhan, China. JAMA Oncol; Advance online publication 30 July 2020. doi: 10.1001/jamaoncol.2020.2783