key: cord-0706522-f3bl0gli
authors: Jiang, Yao; Li, Guiling; Xing, Biyuan; Wang, Ye; Liu, Zhao; Zhao, Yingchao
title: Brachytherapy Care during the COVID-19 Pandemic: Practice Statement from a Cancer Center in Wuhan, China
date: 2020-08-26
journal: Brachytherapy
DOI: 10.1016/j.brachy.2020.08.005
sha: 4271d2496e567b4cc3569e988f7a4d7ab55fef38
doc_id: 706522
cord_uid: f3bl0gli

Purpose COVID-19 broke out in late 2019 and rapidly spread around the world and became a pandemic. This highly contagious disease affects routine health care services and cancer patients who are susceptible to it. Delivering brachytherapy on time is critical for cancer patients to get better prognosis. The purpose of this study is to present workflow and standard for radiation centers to deliver brachytherapy and avoid cross-infection during the COVID-19 pandemic. Methods and Materials This study combined previous literature and guidelines of precaution with clinical experience in the COVID-19 pandemic. Results A workflow covering patients’ screening, health care workers’ precaution, training, and other aspects of the whole brachytherapy procedure was established. Conclusions From the reopening of radiation center to mid-May in 2020, there is no hospital infection of COVID-19 in patients or healthcare workers. This recommendation is effective and helpful to other cancer centers.

RetroEMBRACE research on cervical cancer indicated that overall treatment times (OTT) of less than 46 seven weeks were associated with a higher, three-year local control rate (86%-94%); in contrast, 47 whereas an OTT of more than seven weeks needed an additional 5 Gy to compensate the loss of local 48 control [8] . Even with chemotherapy, OTT (treatment includes external-beam radiotherapy and 49 brachytherapy) greater than 56 days had a pelvic failure rate of 26% while OTT less than 56 days had a 50 9% failure rate. Both failure rates were determined for locally advanced cervical cancer [9] . Studies 51 indicated that intervals from surgery to adjuvant radiotherapy greater than eight weeks led to higher period from a COVID-19 infection. Patients and companions with negative screening results are 66 assigned to isolation wards (one ward per patient). After observation for three days, we transfer 67 patients into regular wards who have a negative nucleic acid re-test result (sampling interval for at 68 least 24 hours) and exhibit no COVID-19 symptoms (Fig. 1a) . Isolation for more than 14 days post 69 recovery, until each individual was no longer contagious, was required for COVID-19 infected 

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Both patients and companions are required to undergo 220 chest CT scanning, antibody testing for specific IgM/IgG antibody against SARS-CoV-2, and a throat 221 swab nucleic acid test. Ideally, we suggest that the patient should arrive without a companion; however, 222 fixed one-to-one companionship is permitted due to necessity. b. Diagram of the emergency response 223 plan of newly diagnosed COVID-19 patients during brachytherapy. c. Zoning of the brachytherapy 224 center