key: cord-0797050-i2krxtlk authors: Hathout, Lara; Ennis, Ronald; Mattes, Malcolm D.; Wagman, Raquel; Grann, Alison; Jabbour, Salma K.; Singh, Rachana; Yue, Ning; Haffty, Bruce; Vergalasova, Irina title: The Impact of COVID-19 on brachytherapy during the pandemic: a Rutgers-Robert Wood Johnson Barnabas Health multi-site experience date: 2020-11-02 journal: Adv Radiat Oncol DOI: 10.1016/j.adro.2020.10.013 sha: 0c857599880ab8be2b5f1fd2ed36a7e3e5ab3cd8 doc_id: 797050 cord_uid: i2krxtlk PURPOSE: /Objectives: To evaluate whether the COVID-19 pandemic resulted in treatment delays in patients scheduled for or undergoing brachytherapy. MATERIALS/METHODS: A retrospective cohort study was conducted across four affiliated sites following local Institutional Review Board approval. Eligibility criteria were defined as all patients with cancer whose treatment plan included brachytherapy during the COVID-19 pandemic from 2/24/2020 to 6/30/2020. Treatment delays, cancellations, alterations of fractionation regimens and treatment paradigm changes were evaluated. RESULTS: A total of 47 patients were eligible for analysis. The median age at time of treatment was 62 (Inter Quartile Range 56-70). Endometrial, cervical and prostate cancers were the most common sites included in this analysis. Three patients (6.4%) with cervical cancer were diagnosed with COVID-19 during the course of their treatment. Interruptions of EBRT, cancellations of EBRT, cancellations of brachytherapy and treatment delays due to COVID occurred in 5 (10.6%), 3 (6.4%), 8 (17%) and 9 (19%) patients, respectively. The mean and median number of days delayed for patients who experienced treatment interruptions were 16.3 days (Std dev=13.9) and 14 days (IQR=5.75-23.75), respectively. For cervical cancer patients, the mean and median overall treatment time defined as time from start of EBRT to end of brachytherapy were 56 and 49 days, respectively. CONCLUSIONS: Despite the challenges the healthcare system faced during the pandemic, it is reassuring to report that most patients with cancer were safely treated with minor treatment delays and interruptions. Long-term follow-up is needed to assess the impact of COVID-19 and treatment interruptions on oncological outcomes. A retrospective cohort study was conducted to collect clinical, pathologic, radiologic, 53 demographic, and treatment parameters across four affiliated sites following local Institutional 54 Review Board approval. Eligibility criteria were defined as patients with cancer who received or 55 were scheduled to receive brachytherapy as part of their treatment course during the COVID-19 56 pandemic from 2/24/2020 to 6/30/2020. Patients treated during that time who decided to 57 cancel or interrupt their treatment course as well as patients who changed their treatment 58 options due to the pandemic were included. Treatment delays, cancellations, alteration of 59 fractionation regimens and treatment paradigm changes were evaluated. The final cohort 60 included 47 patients eligible for analysis. 61 The radiation oncology departments enforced strict guidelines during the pandemic 62 including temperature checks for patients and staff, pre-screening for COVID-19 symptoms 63 before each patient visit, social distancing in the waiting room, limiting visitors, providing 64 surgical masks to patients, as well as personal protective equipment for the staff, as part of the 65 initiatives within the respective hospitals. Telemedicine visits were implemented initially for 66 minimize exposure by alternating morning and afternoon shifts. Descriptive and frequency 68 statistics were used to characterize baseline clinical and treatment characteristics. Mean and 69 median were used to determine treatment delays. 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