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Lessons Learned From Hurricane Maria in Puerto Rico: Practical Measures to Mitigate the Impact of a Catastrophic Natural Disaster on Radiation Oncology Patients.

Publication ,  Journal Article
Gay, HA; Santiago, R; Gil, B; Remedios, C; Montes, PJ; López-Araujo, J; Chévere, CM; Imbert, WS; White, J; Arthur, DW; Horton, JK; Jagsi, R ...
Published in: Pract Radiat Oncol
2019

PURPOSE: Although the wind, rain, and flooding of Hurricane Maria in Puerto Rico abated shortly after its landfall on September 20, 2017, the disruption of the electrical, communications, transportation, and medical infrastructure of the island was unprecedented in scope and caused lasting harm for many months afterward. A compilation of recommendations from radiation oncologists who were in Puerto Rico during the disaster, and from a panel of American Society for Radiation Oncology (ASTRO) cancer experts was created. METHODS AND MATERIALS: Radiation oncologists throughout Puerto Rico collaborated and improvised to continue treating patients in the immediate aftermath of the storm and as routine clinical operations were restored gradually. Empirical lessons from the experience of radiation therapy administration in this profoundly altered context of limited resources, impaired communication, and inadequate transportation were organized into a recommended template, applicable to any radiation oncology practice. ASTRO disease-site experts provided evidence-guidelines for mitigating the impact of a 2- to 3-week interruption in radiation therapy. RESULTS: Practical measures to mitigate the medical impact of a disaster are summarized within the framework of "Prepare, Communicate, Operate, Compensate." Specific measures include the development of an emergency operations plan tailored to specific circumstances, prospective coordination with other radiation oncology clinics before a disaster, ongoing communications with emergency management organizations, and routine practice of alternate methods to disseminate information among providers and patients. CONCLUSIONS: These recommendations serve as a starting point to assist any radiation oncology practice in becoming more resiliently prepared for a local or regional disruption from any cause. Disease-site experts provide evidence-based guidelines on how to mitigate the impact of a 2- to 3-week interruption in radiation therapy for lung, head and neck, uterine cervix, breast, and prostate cancers through altered fractionation or dose escalation.

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Published In

Pract Radiat Oncol

DOI

EISSN

1879-8519

Publication Date

2019

Volume

9

Issue

5

Start / End Page

305 / 321

Location

United States

Related Subject Headings

  • Radiation Oncology
  • Puerto Rico
  • Natural Disasters
  • Humans
  • Cyclonic Storms
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
 

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ICMJE
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Gay, H. A., Santiago, R., Gil, B., Remedios, C., Montes, P. J., López-Araujo, J., … Lee Burnett, O. (2019). Lessons Learned From Hurricane Maria in Puerto Rico: Practical Measures to Mitigate the Impact of a Catastrophic Natural Disaster on Radiation Oncology Patients. Pract Radiat Oncol, 9(5), 305–321. https://doi.org/10.1016/j.prro.2019.03.007
Gay, Hiram A., Roberto Santiago, Betty Gil, Carlos Remedios, Pedro J. Montes, Javier López-Araujo, Carlos M. Chévere, et al. “Lessons Learned From Hurricane Maria in Puerto Rico: Practical Measures to Mitigate the Impact of a Catastrophic Natural Disaster on Radiation Oncology Patients.Pract Radiat Oncol 9, no. 5 (2019): 305–21. https://doi.org/10.1016/j.prro.2019.03.007.
Gay HA, Santiago R, Gil B, Remedios C, Montes PJ, López-Araujo J, et al. Lessons Learned From Hurricane Maria in Puerto Rico: Practical Measures to Mitigate the Impact of a Catastrophic Natural Disaster on Radiation Oncology Patients. Pract Radiat Oncol. 2019;9(5):305–21.
Gay, Hiram A., et al. “Lessons Learned From Hurricane Maria in Puerto Rico: Practical Measures to Mitigate the Impact of a Catastrophic Natural Disaster on Radiation Oncology Patients.Pract Radiat Oncol, vol. 9, no. 5, 2019, pp. 305–21. Pubmed, doi:10.1016/j.prro.2019.03.007.
Gay HA, Santiago R, Gil B, Remedios C, Montes PJ, López-Araujo J, Chévere CM, Imbert WS, White J, Arthur DW, Horton JK, Jagsi R, Rabinovich R, Beriwal S, Viswanathan A, Erickson BA, Rengan R, Palma D, Loo BW, Kavanaugh JA, Bradley J, Yom SS, Harari PM, Lee Burnett O. Lessons Learned From Hurricane Maria in Puerto Rico: Practical Measures to Mitigate the Impact of a Catastrophic Natural Disaster on Radiation Oncology Patients. Pract Radiat Oncol. 2019;9(5):305–321.
Journal cover image

Published In

Pract Radiat Oncol

DOI

EISSN

1879-8519

Publication Date

2019

Volume

9

Issue

5

Start / End Page

305 / 321

Location

United States

Related Subject Headings

  • Radiation Oncology
  • Puerto Rico
  • Natural Disasters
  • Humans
  • Cyclonic Storms
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences