Nadia Montero-Oleas1, Raúl Puente-Vallejo2, Bárbara León-Micheli3, Andrés Imbaquingo-Cabrera4, Mónica Silva5, Elizabeth Gamarra6, Byron Álvarez-Rodas7, Nelson Segovia8, Pablo Aldaz-Roldan9, Cristina Nuñez-Silva10, Karina Zurita-Vivero11, Alex Carrión12, José Molina-Jaramillo13, Andrés Rodríguez-Balarezo14, Yuri Betancourt15, Luis De Los Reyes16. 1. Posgrado de Radioterapia, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador. Address: José Félix Barreiro E15-242 Quito, Ecuador, Código postal: 170209 San Isidro del Inca. Email: nadiamonteromd@gmail.com. ORCID: 0000-0002-5375-3781. 2. Departamento de Radioterapia, Hospital Oncológico SOLCA Núcleo de Quito, Quito, Ecuador. ORCID:0000-0002-0678-2571. 3. Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador. ORCID: 0000-0001-7062-4407. 4. Departamento de Radioterapia, Hospital Oncológico SOLCA Núcleo de Quito, Quito, Ecuador. ORCID: 0000-0002-7287-6357. 5. Servicio de Radioterapia, SOLCA Manabí, Núcleo Portoviejo, Portoviejo, Ecuador. ORCID: 0000-0002-1055-247X. 6. Departamento de Radio-Oncología, Instituto Oncológico Nacional Dr. Juan Tanca Marengo, SOLCA-Guayaquil, Guayaquil, Ecuador. ORCID: 0000-0003-0665-9159. 7. Unidad Académica de Salud y Bienestar, Universidad Católica de Cuenca, Cuenca, Ecuador. ORCID: 0000-0003-2368-2203. 8. Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador. ORCID: 0000-0002-6130-6287. 9. Escuela de Medicina, Departamento de Ciencias de la Salud, Universidad Técnica Particular de Loja, Loja, Ecuador. ORCID: 0000-0002-2677-2215. 10. Departamento de Radioterapia, Hospital Oncológico SOLCA Núcleo de Quito, Quito, Ecuador. ORCID: 0000-0003-4424-611X. 11. Departamento de Radioterapia, Hospital Oncológico SOLCA Núcleo de Quito, Quito, Ecuador. ORCID: 0000-0001-8309-4011. 12. Departamento de Radioterapia, Hospital Oncológico SOLCA Núcleo de Quito, Quito, Ecuador. ORCID: 0000-0003-0650-8123. 13. Unidad Académica de Salud y Bienestar, Universidad Católica de Cuenca, Cuenca, Ecuador, ORCID: 0000-0001-5500-3362. 14. Unidad de Radioterapia, Hospital de Especialidades José Carrasco Arteaga, Cuenca, Ecuador. ORCID: 0000-0003-3238-9471. 15. Posgrado de Radioterapia, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador. ORCID: 0000-0001-8285-0233. 16. Departamento de Radioterapia, Hospital Oncológico SOLCA Núcleo de Quito, Quito, Ecuador. ORCID: 0000-0001-8838-9361.
Abstract
OBJECTIVE: To generate recommendations on the management of radiotherapeutic treatments during the pandemic, adapted to a country with limited health resources. METHODS: We did a rapid review of the literature, searching for papers that describe any measures to reduce the risk of COVID-19 infection, as well as management guidelines to reduce the workload, in radiotherapy units. The following conditions were included in the scope of this review: gynecological tumors, breast cancer, gastrointestinal tumors, genitourinary tumors, head and neck tumors, skin cancer, tumors of the central nervous system, and lymphomas. An expert group discussed online the extracted data and drafted the recommendations. Using a modified Delphi method, the consensus was reached among 14 certificated radio-oncologists. The quality of the evidence that supported the recommendations on treatment schedules was assessed. RESULTS: A total of 57 documents were included. Of these, 25 provided strategies to reduce the risk of infection. Recommendations for each condiction were extracted from the remaining documents. The recommendations aim to establish specific parameters where treatments can be omitted, deferred, prioritized, and shortened. Treatment schemes are recommended for each condition, prioritizing hypo-fractionated schemes whenever possible. CONCLUSIONS: We propose strategies for the management of radiotherapy services to guarantee the continuity of high-quality treatments despite the health crisis caused by COVID-19.
OBJECTIVE: To generate recommendations on the management of radiotherapeutic treatments during the pandemic, adapted to a country with limited health resources. METHODS: We did a rapid review of the literature, searching for papers that describe any measures to reduce the risk of COVID-19 infection, as well as management guidelines to reduce the workload, in radiotherapy units. The following conditions were included in the scope of this review: gynecological tumors, breast cancer, gastrointestinal tumors, genitourinary tumors, head and neck tumors, skin cancer, tumors of the central nervous system, and lymphomas. An expert group discussed online the extracted data and drafted the recommendations. Using a modified Delphi method, the consensus was reached among 14 certificated radio-oncologists. The quality of the evidence that supported the recommendations on treatment schedules was assessed. RESULTS: A total of 57 documents were included. Of these, 25 provided strategies to reduce the risk of infection. Recommendations for each condiction were extracted from the remaining documents. The recommendations aim to establish specific parameters where treatments can be omitted, deferred, prioritized, and shortened. Treatment schemes are recommended for each condition, prioritizing hypo-fractionated schemes whenever possible. CONCLUSIONS: We propose strategies for the management of radiotherapy services to guarantee the continuity of high-quality treatments despite the health crisis caused by COVID-19.
Authors: Cristina M Beltran-Aroca; Rafael Ruiz-Montero; Antonio Llergo-Muñoz; Leticia Rubio; Eloy Girela-López Journal: Int J Environ Res Public Health Date: 2021-11-15 Impact factor: 4.614