Impact of the COVID-19 Pandemic on Outcomes for Patients with Lung Cancer Receiving Curative-intent Radiotherapy in the UK.

Autor: Fornacon-Wood I; University of Manchester, Manchester, UK. Electronic address: Isabella.fornacon-wood@postgrad.manchester.ac.uk., Banfill K; University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK., Ahmad S; Guy's and St Thomas' NHS Foundation Trust, London, UK., Britten A; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Carson C; The Northern Ireland Cancer Centre, Belfast, UK., Dorey N; Torbay and South Devon NHS Foundation Trust, Torquay, UK., Hatton M; Weston Park Hospital, Sheffield, UK., Hiley C; University College London Hospitals, London, UK., Thippu Jayaprakash K; Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Jegannathen A; University Hospitals North Midlands, Stoke on Trent, UK., Kidd AC; Singleton Hospital, Swansea, UK., Koh P; Royal Wolverhampton NHS Trust, Wolverhampton, UK., Panakis N; Oxford University Hospitals NHS Trust, Oxford, UK., Peedell C; The James Cook University Hospital, Middlesborough, UK., Peters A; Beatson West of Scotland Cancer Centre, Glasgow, UK., Pope A; Clatterbridge Cancer Centre, Liverpool, UK., Powell C; Velindre Cancer Centre, Cardiff, UK., Stilwell C; Aberdeen Royal Infirmary, Aberdeen, UK., Thomas B; Swansea Bay University Hospital, Swansea, UK., Toy E; Royal Devon and Exeter NHS Foundation Trust, Exeter, UK., Wicks K; University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK., Wood V; University Hospitals Southampton NHS Foundation Trust, Southampton, UK., Yahya S; University Hospitals Birmingham, Birmingham, UK., Price G; University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK., Faivre-Finn C; University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK.
Jazyk: angličtina
Zdroj: Clinical oncology (Royal College of Radiologists (Great Britain)) [Clin Oncol (R Coll Radiol)] 2023 Oct; Vol. 35 (10), pp. e593-e600. Date of Electronic Publication: 2023 Jul 22.
DOI: 10.1016/j.clon.2023.07.005
Abstrakt: Aims: Previous work found that during the first wave of the COVID-19 pandemic, 34% of patients with lung cancer treated with curative-intent radiotherapy in the UK had a change to their centre's usual standard of care treatment (Banfill et al. Clin Oncol 2022;34:19-27). We present the impact of these changes on patient outcomes.
Materials and Methods: The COVID-RT Lung database was a prospective multicentre UK cohort study including patients with stage I-III lung cancer referred for and/or treated with radical radiotherapy between April and October 2020. Data were collected on patient demographics, radiotherapy and systemic treatments, toxicity, relapse and death. Multivariable Cox and logistic regression were used to assess the impact of having a change to radiotherapy on survival, distant relapse and grade ≥3 acute toxicity. The impact of omitting chemotherapy on survival and relapse was assessed using multivariable Cox regression.
Results: Patient and follow-up forms were available for 1280 patients. Seven hundred and sixty-five (59.8%) patients were aged over 70 years and 603 (47.1%) were female. The median follow-up was 213 days (119, 376). Patients with stage I-II non-small cell lung cancer (NSCLC) who had a change to their radiotherapy had no significant increase in distant relapse (P = 0.859) or death (P = 0.884); however, they did have increased odds of grade ≥3 acute toxicity (P = 0.0348). Patients with stage III NSCLC who had a change to their radiotherapy had no significant increase in distant relapse (P = 0.216) or death (P = 0.789); however, they did have increased odds of grade ≥3 acute toxicity (P < 0.001). Patients with stage III NSCLC who had their chemotherapy omitted had no significant increase in distant relapse (P = 0.0827) or death (P = 0.0661).
Conclusion: This study suggests that changes to radiotherapy and chemotherapy made in response to the COVID-19 pandemic did not significantly affect distant relapse or survival. Changes to radiotherapy, namely increased hypofractionation, led to increased odds of grade ≥3 acute toxicity. These results are important, as hypofractionated treatments can help to reduce hospital attendances in the context of potential future emergency situations.
(Copyright © 2023. Published by Elsevier Ltd.)
Databáze: MEDLINE
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