Brachytherapy in cervical cancer radiotherapy during COVID-19 pandemic crisis: problems and prospects

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Abstract

COVID-19 pandemic has adversely affected general healthcare delivery systems and cancer care throughout the world. The management of locally advanced cervical cancer presents specific challenges in this context, especially brachytherapy and completion of radiotherapy treatment, without compromising the overall treatment time and anticipated outcomes. This article presents in detail the issues and possible solutions with currently available literature for COVID-19 and radiation, in particular brachytherapy management of locally advanced cervical cancers. The review attempts to provide possible explanations and pathways based on COVID-19 testing, brachytherapy processes including application, imaging, and fractionation, keeping in mind the overall treatment time.

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Most cited references 16

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Fair Allocation of Scarce Medical Resources in the Time of Covid-19

Ezekiel J. Emanuel, Govind Persad, Ross Upshur … (2020)

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Global guidance for surgical care during the COVID ‐19 pandemic

Aneel Bhangu, Ismaïl Lawani, Joshua S. Ng-Kamstra … (2020)

Background Surgeons urgently need guidance on how to deliver surgical services safely and effectively during the COVID‐19 pandemic. The aim was to identify the key domains that should be considered when developing pandemic preparedness plans for surgical services. Methods A scoping search was conducted to identify published articles relating to management of surgical patients during pandemics. Key informant interviews were conducted with surgeons and anaesthetists with direct experience of working during infectious disease outbreaks, in order to identify key challenges and solutions to delivering effective surgical services during the COVID‐19 pandemic. Results Thirteen articles were identified from the scoping search, and surgeons and anaesthetists representing 11 territories were interviewed. To mount an effective response to COVID‐19, a pandemic response plan for surgical services should be developed in advance. Key domains that should be included are: provision of staff training (such as patient transfers, donning and doffing personal protection equipment, recognizing and managing COVID‐19 infection); support for the overall hospital response to COVID‐19 (reduction in non‐urgent activities such as clinics, endoscopy, non‐urgent elective surgery); establishment of a team‐based approach for running emergency services; and recognition and management of COVID‐19 infection in patients treated as an emergency and those who have had surgery. A backlog of procedures after the end of the COVID‐19 pandemic is inevitable, and hospitals should plan how to address this effectively to ensure that patients having elective treatment have the best possible outcomes. Conclusion Hospitals should prepare detailed context‐specific pandemic preparedness plans addressing the identified domains. Specific guidance should be updated continuously to reflect emerging evidence during the COVID‐19 pandemic.

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A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 ( COVID ‐19) Pandemic: An International Collaborative Group

Humaid O. Al-Shamsi, Waleed Alhazzani, Ahmad Alhuraiji … (2020)

Abstract The outbreak of coronavirus disease 2019 (COVID‐19) has rapidly spread globally since being identified as a public health emergency of major international concern and has now been declared a pandemic by the World Health Organization (WHO). In December 2019, an outbreak of atypical pneumonia, known as COVID‐19, was identified in Wuhan, China. The newly identified zoonotic coronavirus, severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), is characterized by rapid human‐to‐human transmission. Many cancer patients frequently visit the hospital for treatment and disease surveillance. They may be immunocompromised due to the underlying malignancy or anticancer therapy and are at higher risk of developing infections. Several factors increase the risk of infection, and cancer patients commonly have multiple risk factors. Cancer patients appear to have an estimated twofold increased risk of contracting SARS‐CoV‐2 than the general population. With the WHO declaring the novel coronavirus outbreak a pandemic, there is an urgent need to address the impact of such a pandemic on cancer patients. This include changes to resource allocation, clinical care, and the consent process during a pandemic. Currently and due to limited data, there are no international guidelines to address the management of cancer patients in any infectious pandemic. In this review, the potential challenges associated with managing cancer patients during the COVID‐19 infection pandemic will be addressed, with suggestions of some practical approaches. Implications for Practice The main management strategies for treating cancer patients during the COVID‐19 epidemic include clear communication and education about hand hygiene, infection control measures, high‐risk exposure, and the signs and symptoms of COVID‐19. Consideration of risk and benefit for active intervention in the cancer population must be individualized. Postponing elective surgery or adjuvant chemotherapy for cancer patients with low risk of progression should be considered on a case‐by‐case basis. Minimizing outpatient visits can help to mitigate exposure and possible further transmission. Telemedicine may be used to support patients to minimize number of visits and risk of exposure. More research is needed to better understand SARS‐CoV‐2 virology and epidemiology.

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Journal

Journal ID (nlm-ta): J Contemp Brachytherapy

Journal ID (iso-abbrev): J Contemp Brachytherapy

Journal ID (publisher-id): JCB

Title: Journal of Contemporary Brachytherapy

Publisher: Termedia Publishing House

ISSN (Print): 1689-832X

ISSN (Electronic): 2081-2841

Publication date (Electronic): 30 June 2020

Publication date (Print): June 2020

Volume: 12

Issue: 3

Pages: 290-293

Affiliations

[1]Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

Author notes

Address for correspondence: Umesh Mahantshetty, MD, DNB, Director and Professor, Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre (a unit of Tata Memorial Centre), Visakhapatnam, Andhra Pradesh – 530053, India, e-mail: drumeshm@ 123456gmail.com

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Publisher ID: 41160

DOI: 10.5114/jcb.2020.96873

PMC ID: 7366013

SO-VID: 8c8fbd90-d510-4aa6-9031-93ce105e9cf7

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This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License ( http://creativecommons.org/licenses/by-nc-sa/4.0/)

Brachytherapy in cervical cancer radiotherapy during COVID-19 pandemic crisis: problems and prospects

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Novel Coronavirus Disease COVID-19

Most cited references 16

Fair Allocation of Scarce Medical Resources in the Time of Covid-19

Global guidance for surgical care during the COVID ‐19 pandemic

A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 ( COVID ‐19) Pandemic: An International Collaborative Group

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