COVID-19 impact on timing of brachytherapy treatment and strategies for risk mitigation.

Journal Article

PURPOSE: The purpose of this study was to highlight the importance of timely brachytherapy treatment for patients with gynecologic, breast, and prostate malignancies, and provide a framework for brachytherapy clinical practice and management in response to the COVID-19 pandemic. METHODS AND MATERIALS: We review amassing evidence to help guide the management and timing of brachytherapy for gynecologic, breast, and prostate cancers. Where concrete data could not be found, peer-reviewed expert opinion is provided. RESULTS: There may be a significant negative impact on oncologic outcomes for patients with gynecologic malignancies who have a delay in the timely completion of therapy. Delay of prostate or breast cancer treatment may also impact oncologic outcomes. If a treatment delay is expected, endocrine therapy may be an appropriate temporizing measure before delivery of radiation therapy. The use of shorter brachytherapy fractionation schedules will help minimize patient exposure and conserve resources. CONCLUSIONS: Brachytherapy remains a critical treatment for patients and may shorten treatment time and exposure for some. Reduced patient exposure and resource utilization is important during COVID-19. Every effort should be made to ensure timely brachytherapy delivery for patients with gynecologic malignancies, and endocrine therapy may help temporize treatment delays for breast and prostate cancer patients. Physicians should continue to follow developing institutional, state, and federal guidelines/recommendations as challenges in delivering care during COVID-19 will continue to evolve.

Full Text

Duke Authors

Cited Authors

  • Williams, VM; Kahn, JM; Harkenrider, MM; Chino, J; Chen, J; Fang, LC; Dunn, EF; Fields, E; Mayadev, JS; Rengan, R; Petereit, D; Dyer, BA

Published Date

  • July 2020

Published In

Volume / Issue

  • 19 / 4

Start / End Page

  • 401 - 411

PubMed ID

  • 32359937

Pubmed Central ID

  • 32359937

Electronic International Standard Serial Number (EISSN)

  • 1873-1449

Digital Object Identifier (DOI)

  • 10.1016/j.brachy.2020.04.005

Language

  • eng

Conference Location

  • United States