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. 2013 Feb 21;2(2):109–113. doi: 10.3816/SCT.2005.n.004

Impact of Severe Acute Respiratory Syndrome on Patient Access to Palliative Radiation Therapy

Justin Lee a,d, Lori Holden b,d, Kinwah Fung c,d, Cyril Danjoux a,d, Edward Chow a,d, Carol Gillies b,d,*
PMCID: PMC7129567  PMID: 18628197

Abstract

This study evaluated the impact of the severe acute respiratory syndrome (SARS) epidemic on access and utilization of palliative radiation therapy (RT) at a single institution using a retrospective chart review. A total of 649 patients seen between January and May 2002 and between January and May 2003 were evaluated. Treatment characteristics and waiting times were recorded. March 20 to May 30, 2003, was defined as the peak period of incidence and was compared with the same period in 2002. During the SARS epidemic, there was a 21% decrease in the number of patient consultations and a 15% reduction in the number of patients treated with RT. There was no significant change in the tumor type or reason for referral. Short fractionation schedules were employed for 35% of treated patients compared with 34% in 2002. Patient waiting times between referral and treatment decreased during the period of interest, from 16 days to 8 days (P = 0.021). This study demonstrates a reduction in palliative RT services that is similar in magnitude to decreases observed in other essential cancer services during the SARS epidemic. Use of single-fraction RT and delayed follow-up visits may help to minimize hospital transfers and visits in the event of future infectious disease outbreaks.

Key words: Critical cancer services, Palliative radiation therapy, Resource utilization

References

  • 1.Health Canada. Summary of severe acute respiratory syndrome (SARS) cases: Canada and International [Web page]. Ottawa: Health Canada, 2003. Available at: www.phac-aspc.gc.ca/sars-sras/sars.html#numbers Accessed May 20, 2004.
  • 2.Svoboda T, Henry B, Shulman L. Public health measures to control the spread of the severe acute respiratory syndrome during the outbreak in Toronto. N Engl J Med. 2004;350:2352–2361. doi: 10.1056/NEJMoa032111. [DOI] [PubMed] [Google Scholar]
  • 3.Dwosh HA, Hong HH, Austgarden D. Identification and containment of an outbreak of SARS in a community hospital. CMAJ. 2003;168:1415–1420. [PMC free article] [PubMed] [Google Scholar]
  • 4.Woodward G, Stukel T, Schull M. Utilization of Ontario's health system during the 2003 SARS outbreak. Institute for Clinical Evaluative Sciences (ICES) Investigative Report. Institute for Clinical Evaluative Sciences; Toronto: May 2004. [Google Scholar]
  • 5.Booth CM, Matukas LM, Tomlinson GA. Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area. JAMA. 2003;289:2801–2809. doi: 10.1001/jama.289.21.JOC30885. [DOI] [PubMed] [Google Scholar]
  • 6.Poutanen SM, Low DE, Henry B. Identification of severe acute respiratory syndrome in Canada. National Microbiology Laboratory, Canada; Canadian Severe Acute Respiratory Syndrome Study Team. N Engl J Med. 2003;348:1995–2005. doi: 10.1056/NEJMoa030634. [DOI] [PubMed] [Google Scholar]
  • 7.Nickell LA, Crighton EJ, Tracy CS. Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution. CMAJ. 2004;170:793–798. doi: 10.1503/cmaj.1031077. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Loblaw DA, Laperriere NJ. Emergency treatment of malignant extradural spinal cord compression: an evidence-based guideline. J Clin Oncol. 1998;16:1613–1624. doi: 10.1200/JCO.1998.16.4.1613. [DOI] [PubMed] [Google Scholar]
  • 9.Wu JS, Wong R, Johnston M. Cancer Care Ontario Practice Guidelines Initiative Supportive Care Group. Meta-analysis of dosefractionation radiotherapy trials for the palliation of painful bone metastases. Int J Radiat Oncol Biol Phys. 2003;55:594–605. doi: 10.1016/s0360-3016(02)04147-0. [DOI] [PubMed] [Google Scholar]
  • 10.Bone Pain Trial Working Party. 8 Gy single fraction radiotherapy for the treatment of metastatic skeletal pain: randomized comparison with a multifraction schedule over 12 months of patient follow-up. Bone Pain Trial Working Party. Radiother Oncol. 1999;52:111–121. [PubMed] [Google Scholar]
  • 11.Chow E, Hruby G, Davis L. Quality of life after local external beam radiotherapy for symptomatic bone metastasis – a prospective evaluation. Support Cancer Ther. 2004;1:179–185. doi: 10.3816/SCT.2004.n.009. [DOI] [PubMed] [Google Scholar]
  • 12.Bernstein A. Canadian Institutes of Health Research. SARS: make no mistake—there will be a next time. Hosp Q. 2003;6:21–22. doi: 10.12927/hcq..16486. [DOI] [PubMed] [Google Scholar]
  • 13.Weinstein RA. Planning for epidemics—the lessons of SARS. N Engl J Med. 2004;350:2332–2334. doi: 10.1056/NEJMp048082. [DOI] [PubMed] [Google Scholar]

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