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Changes in the Management of Patients having Radical Radiotherapy for Lung Cancer during the First Wave of the COVID-19 Pandemic in the UK
AIMS: In response to the COVID-19 pandemic, guidelines on reduced fractionation for patients treated with curative-intent radiotherapy were published, aimed at reducing the number of hospital attendances and potential exposure of vulnerable patients to minimise the risk of COVID-19 infection. We des...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Authors. Published by Elsevier Ltd on behalf of The Royal College of Radiologists.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552552/ https://www.ncbi.nlm.nih.gov/pubmed/34763964 http://dx.doi.org/10.1016/j.clon.2021.10.009 |
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author | Banfill, K. Croxford, W. Fornacon-Wood, I. Wicks, K. Ahmad, S. Britten, A. Carson, C. Dorey, N. Hatton, M. Hiley, C. Thippu Jayaprakash, K. Jegannathen, A. Koh, P. Panakis, N. Peedell, C. Pope, A. Powell, C. Stilwell, C. Thomas, B. Toy, E. Wood, V. Yahya, S. Zhou, S.Y. Price, G. Faivre-Finn, C. |
author_facet | Banfill, K. Croxford, W. Fornacon-Wood, I. Wicks, K. Ahmad, S. Britten, A. Carson, C. Dorey, N. Hatton, M. Hiley, C. Thippu Jayaprakash, K. Jegannathen, A. Koh, P. Panakis, N. Peedell, C. Pope, A. Powell, C. Stilwell, C. Thomas, B. Toy, E. Wood, V. Yahya, S. Zhou, S.Y. Price, G. Faivre-Finn, C. |
author_sort | Banfill, K. |
collection | PubMed |
description | AIMS: In response to the COVID-19 pandemic, guidelines on reduced fractionation for patients treated with curative-intent radiotherapy were published, aimed at reducing the number of hospital attendances and potential exposure of vulnerable patients to minimise the risk of COVID-19 infection. We describe the changes that took place in the management of patients with stage I–III lung cancer from April to October 2020. MATERIALS AND METHODS: Lung Radiotherapy during the COVID-19 Pandemic (COVID-RT Lung) is a prospective multicentre UK cohort study. The inclusion criteria were: patients with stage I–III lung cancer referred for and/or treated with radical radiotherapy between 2nd April and 2nd October 2020. Patients who had had a change in their management and those who continued with standard management were included. Data on demographics, COVID-19 diagnosis, diagnostic work-up, radiotherapy and systemic treatment were collected and reported as counts and percentages. Patient characteristics associated with a change in treatment were analysed using multivariable binary logistic regression. RESULTS: In total, 1553 patients were included (median age 72 years, 49% female); 93 (12%) had a change to their diagnostic investigation and 528 (34%) had a change to their treatment from their centre's standard of care as a result of the COVID-19 pandemic. Age ≥70 years, male gender and stage III disease were associated with a change in treatment on multivariable analysis. Patients who had their treatment changed had a median of 15 fractions of radiotherapy compared with a median of 20 fractions in those who did not have their treatment changed. Low rates of COVID-19 infection were seen during or after radiotherapy, with only 21 patients (1.4%) developing the disease. CONCLUSIONS: The COVID-19 pandemic resulted in changes to patient treatment in line with national recommendations. The main change was an increase in hypofractionation. Further work is ongoing to analyse the impact of these changes on patient outcomes. |
format | Online Article Text |
id | pubmed-8552552 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Authors. Published by Elsevier Ltd on behalf of The Royal College of Radiologists. |
record_format | MEDLINE/PubMed |
spelling | pubmed-85525522021-10-28 Changes in the Management of Patients having Radical Radiotherapy for Lung Cancer during the First Wave of the COVID-19 Pandemic in the UK Banfill, K. Croxford, W. Fornacon-Wood, I. Wicks, K. Ahmad, S. Britten, A. Carson, C. Dorey, N. Hatton, M. Hiley, C. Thippu Jayaprakash, K. Jegannathen, A. Koh, P. Panakis, N. Peedell, C. Pope, A. Powell, C. Stilwell, C. Thomas, B. Toy, E. Wood, V. Yahya, S. Zhou, S.Y. Price, G. Faivre-Finn, C. Clin Oncol (R Coll Radiol) Original Article AIMS: In response to the COVID-19 pandemic, guidelines on reduced fractionation for patients treated with curative-intent radiotherapy were published, aimed at reducing the number of hospital attendances and potential exposure of vulnerable patients to minimise the risk of COVID-19 infection. We describe the changes that took place in the management of patients with stage I–III lung cancer from April to October 2020. MATERIALS AND METHODS: Lung Radiotherapy during the COVID-19 Pandemic (COVID-RT Lung) is a prospective multicentre UK cohort study. The inclusion criteria were: patients with stage I–III lung cancer referred for and/or treated with radical radiotherapy between 2nd April and 2nd October 2020. Patients who had had a change in their management and those who continued with standard management were included. Data on demographics, COVID-19 diagnosis, diagnostic work-up, radiotherapy and systemic treatment were collected and reported as counts and percentages. Patient characteristics associated with a change in treatment were analysed using multivariable binary logistic regression. RESULTS: In total, 1553 patients were included (median age 72 years, 49% female); 93 (12%) had a change to their diagnostic investigation and 528 (34%) had a change to their treatment from their centre's standard of care as a result of the COVID-19 pandemic. Age ≥70 years, male gender and stage III disease were associated with a change in treatment on multivariable analysis. Patients who had their treatment changed had a median of 15 fractions of radiotherapy compared with a median of 20 fractions in those who did not have their treatment changed. Low rates of COVID-19 infection were seen during or after radiotherapy, with only 21 patients (1.4%) developing the disease. CONCLUSIONS: The COVID-19 pandemic resulted in changes to patient treatment in line with national recommendations. The main change was an increase in hypofractionation. Further work is ongoing to analyse the impact of these changes on patient outcomes. The Authors. Published by Elsevier Ltd on behalf of The Royal College of Radiologists. 2022-01 2021-10-28 /pmc/articles/PMC8552552/ /pubmed/34763964 http://dx.doi.org/10.1016/j.clon.2021.10.009 Text en © 2021 The Authors Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Article Banfill, K. Croxford, W. Fornacon-Wood, I. Wicks, K. Ahmad, S. Britten, A. Carson, C. Dorey, N. Hatton, M. Hiley, C. Thippu Jayaprakash, K. Jegannathen, A. Koh, P. Panakis, N. Peedell, C. Pope, A. Powell, C. Stilwell, C. Thomas, B. Toy, E. Wood, V. Yahya, S. Zhou, S.Y. Price, G. Faivre-Finn, C. Changes in the Management of Patients having Radical Radiotherapy for Lung Cancer during the First Wave of the COVID-19 Pandemic in the UK |
title | Changes in the Management of Patients having Radical Radiotherapy for Lung Cancer during the First Wave of the COVID-19 Pandemic in the UK |
title_full | Changes in the Management of Patients having Radical Radiotherapy for Lung Cancer during the First Wave of the COVID-19 Pandemic in the UK |
title_fullStr | Changes in the Management of Patients having Radical Radiotherapy for Lung Cancer during the First Wave of the COVID-19 Pandemic in the UK |
title_full_unstemmed | Changes in the Management of Patients having Radical Radiotherapy for Lung Cancer during the First Wave of the COVID-19 Pandemic in the UK |
title_short | Changes in the Management of Patients having Radical Radiotherapy for Lung Cancer during the First Wave of the COVID-19 Pandemic in the UK |
title_sort | changes in the management of patients having radical radiotherapy for lung cancer during the first wave of the covid-19 pandemic in the uk |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552552/ https://www.ncbi.nlm.nih.gov/pubmed/34763964 http://dx.doi.org/10.1016/j.clon.2021.10.009 |
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