Looking Back: International Practice Patterns in Breast Radiation Oncology From a Case-Based Survey Across 54 Countries During the First Surge of the COVID-19 Pandemic.
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Oladeru Oluwadamilola T, Dunn Samantha A, Li Jian, Coles Charlotte E, Yamauchi Chikako, Chang Jee Suk, Cheng Skye Hung-Chun, Kaidar-Person Orit, Meattini Icro, Ramiah Duvern, Kirby Anna, Hijal Tarek, Marta Gustavo Nader, Poortmans Philip, Isern-Verdum Josep, Zissiadis Yvonne, Offersen Birgitte Vrou, Refaat Tamer, Elsayad Khaled, Hijazi Hussam, Dengina Natalia, Belkacemi Yazid, Luo Feng Deng, Lu Shun, Griffin Colleen, Collins Maya, Ryan Phoebe, Larios Dalia, Warren Laura E, Punglia Rinaa S, Wong Julia S, Spiegel Daphna Y, Jagsi Reshma, Taghian Alphonse, Bellon Jennifer R, Ho Alice Y
Аннотация
MATERIALS AND METHODS: Between July and November 2020, a 58-question survey was distributed to radiation oncologists (ROs) through international professional societies. Changes in RT decision making during the first surge of the pandemic were evaluated across six hypothetical scenarios, including the management of ductal carcinoma in situ (DCIS), early-stage, locally advanced, and metastatic BC. The significance of changes in responses before and during the pandemic was examined using chi-square and McNemar-Bowker tests.
RESULTS: One thousand one hundred three ROs from 54 countries completed the survey. Incomplete responses (254) were excluded from the analysis. Most respondents were from the United States (285), Japan (117), Italy (63), Canada (58), and Brazil (56). Twenty-one percent (230) of respondents reported treating at least one patient with BC who was COVID-19-positive. Approximately 60% of respondents reported no change in treatment recommendation during the pandemic, except for patients with metastatic disease, for which 57.7% (636/1,103; P < .0005) changed their palliative practice. Among respondents who noted a change in their recommendation during the first surge of the pandemic, omitting, delaying, and adopting short-course RT were the most frequent changes, with most transitioning to moderate hypofractionation for DCIS and early-stage BC.
CONCLUSION: Early in the COVID-19 pandemic, significant changes in global RT practice patterns for BC were introduced. The impact of published results from the FAST FORWARD trial supporting ultrahypofractionation likely confounded the interpretation of the pandemic's independent influence on RT delivery.