1.
At present, the outbreak of novel coronavirus (COVID‐19) infection pneumonia, which was first reported in Wuhan city, Hubei province, China, has evolved from locoregional public health events to pandemic public health emergency involving more than 154 countries and regions (Huang et al., 2020). As of 28 March 2020, cumulative identified infection in the world except China is 489,448 cases and 23,193(4.7%) cases of them have passed away. A study reported that cancer patients have higher risk of infection, severe symptoms, more rapid deterioration and poorer outcome once infected, compared with non‐cancer patients, due to older age, smoking history, diverse comorbidities and the immunosuppressive status after chemotherapy, surgery or even immune checkpoint blockade (ICB) regimen(Liang et al., 2020). Although the subsequent comments doubted whether it is sufficient to conclude the association between cancer with COVID‐19, the first report concerning COVID‐19 sufferers with cancer indeed proposed the close attention on the protection of cancer patients that was previously neglected (Wang & Zhang, 2020; Xia, Jin, Zhao, Li, & Shen, 2020).
It is estimated that approximately 50%–60% of cancer patients require radiotherapy (Weichselbaum, Liang, Deng, & Fu, 2017). At the onset of the outbreak, cancer patients were in different stages of radiotherapy, such as ongoing radiotherapy, ongoing treatment‐plan designing before radiotherapy and the time point to radiotherapy for concurrent chemoradiotherapy. However, as a result of the long period of radiotherapy, patients have to frequently go to and from the hospital which increases the risk of infection. Thus, how to ensure the progress of radiotherapy for cancer patients, protect patients from COVID‐19, avoid tumour progression as a result of changing radiotherapy strategies and maintain their mental health remain to be problems for radiation oncologists. We share our experience with the public in order to help department of radiation oncology in countries and regions suffering from the epidemic.
First, in order to reduce the risk of personal contact and nosocomial infection of tumour patients, our hospital developed online diagnosis and treatment software platform to provide authoritative online medical services for tumour patients. Patients can customise their treatment strategy with qualified oncologists without leaving their house. The postponing of radiotherapy must be determined on patient‐by‐patient basis and depend on fully evaluating the risk of tumour progression and prognosis on account of the delay. Second, for non‐inpatients who require radiotherapy, temperature screening must be conducted twice a day for both the patients and their companions. Only one companion is allowed throughout the radiotherapy period. Patients and the specified companions should be isolated at home during radiotherapy. When it comes to inpatients, they must be arranged at single ward and receive temperature surveillance four times a day. Daily meals are guaranteed by the department of catering. The surface of all equipment must be sterilised by chlorine‐containing disinfectants/75% alcohol and ventilated for 10 min, four times a day. Suspected cases must be treated by the predesigned procedure (Figure 1). All personnel are supposed to keep one‐meter space apart from each other. Third, we have developed detailed epidemic prevention and management procedures for the outpatients and inpatients and strictly trained for all the medical staff (Figure 1). Special attention should be paid to the differential diagnosis of COVID‐19 with radiation‐related pneumonia, ICB‐related pneumonia, obstructive pneumonia due to cancer progression and other non‐COVID‐19 infectious pneumonia.
Figure 1.
The management procedure of COVID‐19 suspected case in clinic and ward
CONFLICT OF INTEREST
We declared that all authors have no conflict of interest in this work.
AUTHOR CONTRIBUTIONS
S. Wei collected all material and wrote the manuscript. J. Wang conceived the core idea of the study, designed the article frame and supervised this study.
Funding information
This work was supported by the National Natural Science Foundation of China (61631001 to J. Wang).
REFERENCES
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ACKNOWLEDGEMENTS
We thank for the fund support from national natural and science foundation of China.