Table 3.
Radiation Oncology departments organization during COVID-19 pandemic period.
| Recommendations for radiotherapy departments organization | |||
|---|---|---|---|
| Societies/groups/teams | Frenche RO society [39] |
Simcock et al. [22] |
Applicability in LMICs |
| March 19th | March 20th | ||
| Workers protection | |||
| WHO guidelines for preventive measures and use of Personal Protection Equipment (PPE) | X | X | Applicable |
| Reduction of the number of health professionals in radiotherapy departments to the minimum required, promoting teleworking | X | X | Teleworking probably not |
| Inviting the local Infection Control department | X | ||
| Temperature monitoring for all patients | X | Applicable | |
| Special monitoring for ‘contact’ patients (those who had close contact with confirmed COVID cases) | X | Probably not | |
| Symptomatic health professional: PCR, isolation, adapted care | X | Probably not | |
| Department Organization | |||
| Delay of follow-up medical examinations | X | Applicable | |
| Remote/telephone consultation when possible | X | X | Probably not |
| Minimize number of additional visitors, family members or careers | X | Applicable | |
| Reorganization of waiting rooms (separating fragile vs potentially infected patients, increased distances, removal of infection vectors) | X | X | |
| Optimize department areas for decontamination | X | ||
| Model for estimation of the harms of COVID infection for cancer patients | X | ||
| Creating capacity by reducing fraction numbers | X | ||
| Separation of fragile/immunocompromised vs infected/contact patients | X | ||
| Special protocol for infected/contact patients (treatment pause or dedicated treatment timeslot) | X | X | |
| When Insufficient Number Of Health Professionals | |||
| Priority to: primary radiation treatments (vs operable or adjuvant), curative (vs palliative) | X | X | Applicable |
| Delay treatment for hormone-sensitive cancersa | X | ||
| Record all changes in treatments | X | ||
| Only one therapist per treatment (standard) | X | ||
| Two therapist per treatment (complex treatments) | X | ||
| Turnover for radiation oncologists and medical physicist | X | ||
| Brachytherapy | |||
| Delay of all brachytherapy treatments | X | Applicable | |
| Prefer local/spine anaesthesia to general anaesthesia | X | ||
| Delay of treatments where surveillance is an alternative option | X | ||
| Priority to: primary treatments (vs adjuvant), single treatment (vs fractionated) | X | ||
| FFP2 masks for head and neck treatments | X | ||
| Special cases dealt with | |||
| Insufficient number of medical physicists | X | Applicable | |
| Insufficient number of radiation oncologists | X | ||
| Increase of quality control hours and prioritization of checks | X | ||
| Specific indications for omitting/delaying/hypofractionating/pausing radiotherapy treatment by cancer type and curative vs palliative treatment | X | ||
COVID-19, coronavirus disease 2019; LMICs, low- and middle-income countries.
a
With attention on a post-crisis unmanageable surge in activity. RO: radiation oncology.