Elsevier

Brachytherapy

Volume 19, Issue 4, July–August 2020, Pages 401-411
Brachytherapy

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

https://doi.org/10.1016/j.brachy.2020.04.005Get rights and content

Abstract

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.

Keywords

Coronavirus
COVID19
COVID-19
Cervical cancer
Uterine cancer
Breast cancer
Prostate cancer
Brachytherapy
Radiotherapy
Radiation oncology

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Disclosures: The authors declare no conflict of interest. There are no funding sources to disclose. There were no grants, monies, or other financial incentives or coercions used or offered in the preparation of this article. This article has not been presented or published, in part or in full, before this submission.

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Equally contributing authors.

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