Prostate Cancer Radiotherapy Recommendations in Response to COVID-19
Identifieur interne : 000201 ( Pmc/Checkpoint ); précédent : 000200; suivant : 000202Prostate Cancer Radiotherapy Recommendations in Response to COVID-19
Auteurs : Nicholas G. ZaorskySource :
- Advances in Radiation Oncology [ 2452-1094 ] ; 2020.
Abstract
During a global pandemic the benefit of routine visits and treatment of cancer patients must be weighed against the risks to patients, staff, and society. Prostate cancer is one of the most common cancers Radiation Oncology departments treat, and efficient resource utilization is essential in the setting of a pandemic. Herein, we aim to establish recommendations and a framework by which to evaluate prostate radiotherapy management decisions.
Radiation Oncologists from the United States and United Kingdom rapidly conducted a systematic review and agreed upon recommendations to safely manage prostate cancer patients during the COVID-19 pandemic. A RADS framework was created: Remote visits, and Avoidance, Deferment, and Shortening of radiotherapy was applied to determine appropriate approaches.
Recommendations are provided by National Comprehensive Cancer Network (NCCN) risk group, including clinical node positive, post-prostatectomy, oligometastatic, and low volume M1 disease. Across all prostate cancer stages, telemedicine consultations and return visits were recommended when resources/staff available. Delays in consultations and return visits was deemed safe based on stage of disease between 1-6 months. Treatment can be avoided or delayed until safe for very low, low, and favorable intermediate-risk disease. Unfavorable intermediate-risk, high-risk, clinical node positive, recurrence post-surgery, oligometastatic, and low-volume M1 disease can receive neoadjuvant hormone therapy for 4-6 months as necessary. Ultrahypofractionation was preferred for localized, oligometastatic, and low volume M1, and moderate hypofractionation was preferred for post-prostatectomy and clinical node positive disease. Salvage was preferred to adjuvant radiation.
Resources can be reduced for all identified stages of prostate cancer. The RADS (Remote visits, and Avoidance, Deferment, and Shortening of radiotherapy) framework can be applied to other disease sites to help with decision making in a global pandemic.
Url:
DOI: 10.1016/j.adro.2020.03.010
PubMed: NONE
PubMed Central: 7118610
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Zaorsky</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">7118610</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118610</idno><idno type="RBID">PMC:7118610</idno><idno type="doi">10.1016/j.adro.2020.03.010</idno><idno type="pmid">NONE</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000594</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000594</idno><idno type="wicri:Area/Pmc/Curation">000594</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000594</idno><idno type="wicri:Area/Pmc/Checkpoint">000201</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000201</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Prostate Cancer Radiotherapy Recommendations in Response to COVID-19</title><author><name sortKey="Zaorsky, Nicholas G" sort="Zaorsky, Nicholas G" uniqKey="Zaorsky N" first="Nicholas G." last="Zaorsky">Nicholas G. Zaorsky</name></author></analytic><series><title level="j">Advances in Radiation Oncology</title><idno type="eISSN">2452-1094</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>During a global pandemic the benefit of routine visits and treatment of cancer patients must be weighed against the risks to patients, staff, and society. Prostate cancer is one of the most common cancers Radiation Oncology departments treat, and efficient resource utilization is essential in the setting of a pandemic. Herein, we aim to establish recommendations and a framework by which to evaluate prostate radiotherapy management decisions.</p></sec><sec><title>Patients and Methods</title><p>Radiation Oncologists from the United States and United Kingdom rapidly conducted a systematic review and agreed upon recommendations to safely manage prostate cancer patients during the COVID-19 pandemic. A RADS framework was created: Remote visits, and Avoidance, Deferment, and Shortening of radiotherapy was applied to determine appropriate approaches.</p></sec><sec><title>Results</title><p>Recommendations are provided by National Comprehensive Cancer Network (NCCN) risk group, including clinical node positive, post-prostatectomy, oligometastatic, and low volume M1 disease. Across all prostate cancer stages, telemedicine consultations and return visits were recommended when resources/staff available. Delays in consultations and return visits was deemed safe based on stage of disease between 1-6 months. Treatment can be avoided or delayed until safe for very low, low, and favorable intermediate-risk disease. Unfavorable intermediate-risk, high-risk, clinical node positive, recurrence post-surgery, oligometastatic, and low-volume M1 disease can receive neoadjuvant hormone therapy for 4-6 months as necessary. Ultrahypofractionation was preferred for localized, oligometastatic, and low volume M1, and moderate hypofractionation was preferred for post-prostatectomy and clinical node positive disease. Salvage was preferred to adjuvant radiation.</p></sec><sec><title>Conclusion</title><p>Resources can be reduced for all identified stages of prostate cancer. The RADS (Remote visits, and Avoidance, Deferment, and Shortening of radiotherapy) framework can be applied to other disease sites to help with decision making in a global pandemic.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Liang, W" uniqKey="Liang W">W. 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Morris</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hamdy, F C" uniqKey="Hamdy F">F.C. Hamdy</name></author><author><name sortKey="Donovan, J L" uniqKey="Donovan J">J.L. Donovan</name></author><author><name sortKey="Lane, J" uniqKey="Lane J">J. Lane</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Klotz, L" uniqKey="Klotz L">L. Klotz</name></author><author><name sortKey="Vesprini, D" uniqKey="Vesprini D">D. Vesprini</name></author><author><name sortKey="Sethukavalan, P" uniqKey="Sethukavalan P">P. Sethukavalan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pisansky, T M" uniqKey="Pisansky T">T.M. Pisansky</name></author><author><name sortKey="Hunt, D" uniqKey="Hunt D">D. Hunt</name></author><author><name sortKey="Gomella, L G" uniqKey="Gomella L">L.G. Gomella</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morris, W J" uniqKey="Morris W">W.J. Morris</name></author><author><name sortKey="Tyldesley, S" uniqKey="Tyldesley S">S. Tyldesley</name></author><author><name sortKey="Rodda, S" uniqKey="Rodda S">S. Rodda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zapatero, A" uniqKey="Zapatero A">A. Zapatero</name></author><author><name sortKey="Guerrero, A" uniqKey="Guerrero A">A. Guerrero</name></author><author><name sortKey="Maldonado, X" uniqKey="Maldonado X">X. Maldonado</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Spratt, D" uniqKey="Spratt D">D. Spratt</name></author><author><name sortKey="Dess, R" uniqKey="Dess R">R. Dess</name></author><author><name sortKey="Efstathiou, J" uniqKey="Efstathiou J">J. Efstathiou</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Iversen, P" uniqKey="Iversen P">P. Iversen</name></author><author><name sortKey="Johansson, J E" uniqKey="Johansson J">J.-E. Johansson</name></author><author><name sortKey="Lodding, P" uniqKey="Lodding P">P. Lodding</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kneebone, A" uniqKey="Kneebone A">A. Kneebone</name></author><author><name sortKey="Fraser Browne, C" uniqKey="Fraser Browne C">C. Fraser-Browne</name></author><author><name sortKey="Delprado, W" uniqKey="Delprado W">W. Delprado</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Brand, D H" uniqKey="Brand D">D.H. Brand</name></author><author><name sortKey="Tree, A C" uniqKey="Tree A">A.C. Tree</name></author><author><name sortKey="Ostler, P" uniqKey="Ostler P">P. Ostler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dearnaley, D" uniqKey="Dearnaley D">D. Dearnaley</name></author><author><name sortKey="Syndikus, I" uniqKey="Syndikus I">I. Syndikus</name></author><author><name sortKey="Mossop, H" uniqKey="Mossop H">H. Mossop</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chin, S" uniqKey="Chin S">S. Chin</name></author><author><name sortKey="Fatimilehin, A" uniqKey="Fatimilehin A">A. Fatimilehin</name></author><author><name sortKey="Walshaw, R" uniqKey="Walshaw R">R. Walshaw</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Parker, C C" uniqKey="Parker C">C.C. Parker</name></author><author><name sortKey="James, N D" uniqKey="James N">N.D. James</name></author><author><name sortKey="Brawley, C D" uniqKey="Brawley C">C.D. Brawley</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Widmark, A" uniqKey="Widmark A">A. Widmark</name></author><author><name sortKey="Gunnlaugsson, A" uniqKey="Gunnlaugsson A">A. Gunnlaugsson</name></author><author><name sortKey="Beckman, L" uniqKey="Beckman L">L. Beckman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Widmark, A" uniqKey="Widmark A">A. Widmark</name></author><author><name sortKey="Klepp, O" uniqKey="Klepp O">O. Klepp</name></author><author><name sortKey="Solberg, A" uniqKey="Solberg A">A. Solberg</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Adv Radiat Oncol</journal-id><journal-id journal-id-type="iso-abbrev">Adv Radiat Oncol</journal-id><journal-title-group><journal-title>Advances in Radiation Oncology</journal-title></journal-title-group><issn pub-type="epub">2452-1094</issn><publisher><publisher-name>The Author(s). Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">7118610</article-id><article-id pub-id-type="publisher-id">S2452-1094(20)30061-0</article-id><article-id pub-id-type="doi">10.1016/j.adro.2020.03.010</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Prostate Cancer Radiotherapy Recommendations in Response to COVID-19</article-title></title-group><contrib-group><contrib contrib-type="author" id="au1"><name><surname>Zaorsky</surname><given-names>Nicholas G.</given-names></name></contrib></contrib-group><aff id="aff1">Department of Radiation Oncology, Penn State Cancer Institute, Hershey, PA, USA</aff><contrib-group><contrib contrib-type="author" id="au2"><name><surname>Yu</surname><given-names>James B.</given-names></name></contrib></contrib-group><aff id="aff2">Department of Therapeutic Radiology/Radiation Oncology, Yale, New Haven, CT, USA</aff><contrib-group><contrib contrib-type="author" id="au3"><name><surname>McBride</surname><given-names>Sean M.</given-names></name></contrib></contrib-group><aff id="aff3">Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA</aff><contrib-group><contrib contrib-type="author" id="au4"><name><surname>Dess</surname><given-names>Robert T.</given-names></name></contrib></contrib-group><aff id="aff4">Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA</aff><contrib-group><contrib contrib-type="author" id="au5"><name><surname>Jackson</surname><given-names>William C.</given-names></name></contrib></contrib-group><aff id="aff5">Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA</aff><contrib-group><contrib contrib-type="author" id="au6"><name><surname>Mahal</surname><given-names>Brandon A.</given-names></name></contrib></contrib-group><aff id="aff6">Department of Radiation Oncology, Dana Farber, Boston, MA, USA</aff><contrib-group><contrib contrib-type="author" id="au7"><name><surname>Chen</surname><given-names>Ronald</given-names></name></contrib></contrib-group><aff id="aff7">Department of Radiation Oncology, University of Kansas, Kansas City, KS, USA</aff><contrib-group><contrib contrib-type="author" id="au8"><name><surname>Choudhury</surname><given-names>Ananya</given-names></name></contrib></contrib-group><aff id="aff8">Division of Cancer Sciences, University of Manchester and The Christie NHS Foundation Trust, Manchester, UK</aff><contrib-group><contrib contrib-type="author" id="au9"><name><surname>Henry</surname><given-names>Ann</given-names></name></contrib></contrib-group><aff id="aff9">Department of Clinical Oncology, Leeds Teaching Hospitals NHS Trust and the University of Leeds, Leeds, UK</aff><contrib-group><contrib contrib-type="author" id="au10"><name><surname>Syndikus</surname><given-names>Isabel</given-names></name></contrib></contrib-group><aff id="aff10">Department of Clinical Oncology, The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK</aff><contrib-group><contrib contrib-type="author" id="au11"><name><surname>Mitin</surname><given-names>Timur</given-names></name></contrib></contrib-group><aff id="aff11">Knight Cancer Institute, Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon, USA</aff><contrib-group><contrib contrib-type="author" id="au12"><name><surname>Tree</surname><given-names>Alison</given-names></name></contrib></contrib-group><aff id="aff12">Radiotherapy and Imaging Division, Institute of Cancer Research, Sutton, London, UK</aff><contrib-group><contrib contrib-type="author" id="au13"><name><surname>Kishan</surname><given-names>Amar U.</given-names></name></contrib></contrib-group><aff id="aff13">Department of Radiation Oncology, UCLA, Los Angeles, CA, USA</aff><contrib-group><contrib contrib-type="author" id="au14"><name><surname>Spratt</surname><given-names>Daniel E.</given-names></name><email>sprattda@med.umich.edu</email><xref rid="cor1" ref-type="corresp">#</xref></contrib></contrib-group><aff id="aff14">Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA</aff><author-notes><corresp id="cor1"><label>#</label>Corresponding author: Daniel E Spratt, MD Department of Radiation Oncology University of Michigan 1500 East Medical Center Drive Ann Arbor, MI 48109 Phone: 734 936 9630 <email>sprattda@med.umich.edu</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>1</day><month>4</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>1</day><month>4</month><year>2020</year></pub-date><elocation-id></elocation-id><history><date date-type="received"><day>22</day><month>3</month><year>2020</year></date><date date-type="rev-recd"><day>24</day><month>3</month><year>2020</year></date><date date-type="accepted"><day>24</day><month>3</month><year>2020</year></date></history><permissions><copyright-statement>© 2020 The Author(s)</copyright-statement><copyright-year>2020</copyright-year><license><license-p>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.</license-p></license></permissions><abstract id="abs0010"><sec><title>Purpose</title><p>During a global pandemic the benefit of routine visits and treatment of cancer patients must be weighed against the risks to patients, staff, and society. Prostate cancer is one of the most common cancers Radiation Oncology departments treat, and efficient resource utilization is essential in the setting of a pandemic. Herein, we aim to establish recommendations and a framework by which to evaluate prostate radiotherapy management decisions.</p></sec><sec><title>Patients and Methods</title><p>Radiation Oncologists from the United States and United Kingdom rapidly conducted a systematic review and agreed upon recommendations to safely manage prostate cancer patients during the COVID-19 pandemic. A RADS framework was created: Remote visits, and Avoidance, Deferment, and Shortening of radiotherapy was applied to determine appropriate approaches.</p></sec><sec><title>Results</title><p>Recommendations are provided by National Comprehensive Cancer Network (NCCN) risk group, including clinical node positive, post-prostatectomy, oligometastatic, and low volume M1 disease. Across all prostate cancer stages, telemedicine consultations and return visits were recommended when resources/staff available. Delays in consultations and return visits was deemed safe based on stage of disease between 1-6 months. Treatment can be avoided or delayed until safe for very low, low, and favorable intermediate-risk disease. Unfavorable intermediate-risk, high-risk, clinical node positive, recurrence post-surgery, oligometastatic, and low-volume M1 disease can receive neoadjuvant hormone therapy for 4-6 months as necessary. Ultrahypofractionation was preferred for localized, oligometastatic, and low volume M1, and moderate hypofractionation was preferred for post-prostatectomy and clinical node positive disease. Salvage was preferred to adjuvant radiation.</p></sec><sec><title>Conclusion</title><p>Resources can be reduced for all identified stages of prostate cancer. The RADS (Remote visits, and Avoidance, Deferment, and Shortening of radiotherapy) framework can be applied to other disease sites to help with decision making in a global pandemic.</p></sec></abstract><abstract abstract-type="teaser" id="abs0015"><p>A RADS framework (Remote visits, and Avoidance, Deferment, and Shortening of radiotherapy) was created and applied to determine the appropriate management for men with prostate cancer during the global COVID-19 pandemic. Consensus was reached that all aspects of patient visits, treatment, and overall resource utilization can be reduced for all identified stages of prostate cancer treated with radiotherapy.</p></abstract><kwd-group id="kwrds0010"><title>Keywords</title><kwd>Coronavirus</kwd><kwd>prostate cancer</kwd><kwd>radiotherapy</kwd><kwd>radiation oncology</kwd></kwd-group></article-meta></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Zaorsky, Nicholas G" sort="Zaorsky, Nicholas G" uniqKey="Zaorsky N" first="Nicholas G." last="Zaorsky">Nicholas G. Zaorsky</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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