Influence of Covid-19 Pandemic on Safe and Timely Delivery of Systemic Anti-Cancer Therapy, Dubai Hospital Experience
Journal of Cancer and Tumor International,
Page 81-87
DOI:
10.9734/jcti/2022/v12i4223
Abstract
Aims: To analyze the effect of COVID-19 pandemic on timely delivery of systemic anti-cancer treatment including chemotherapy, biological therapy and immunotherapy and assess complication rate.
Place and Duration of Study: Department of Oncology, Dubai Hospital, Dubai, UAE from January 2020 to July 2020.
Methods: This is a retrospective review of electronic medical records and infusion Centre log of the number of chemotherapy sessions administered in the infusion therapy Centre, Dubai hospital from January 2020 to July 2020. Data on treatment delays, interruptions or discontinuations, and adverse events such as febrile neutropenia were collected and analysed.
Results: A total of 1553 systemic treatment sessions were recorded between January 2020 to July 2020 with an average of 222 treatment sessions per month. Physician recorded delays were observed in ninety (5.79%) treatment sessions. The average treatment delay was 7 (2-13) days. Delays were frequently caused by the overall treatment course and disease-related factors (toxicities, disease progression). The highest number of treatment delays (n=23,10.2%) were recorded in April, at the peak of the Covid-19 pandemic, most likely because of the implementation of extreme precautionary measures. There were no interruptions or discontinuations in treatment.
Fourteen (<1%) patients developed febrile neutropenia. With treatment, all of them recovered fully. No significant change in systemic treatment related complications were observed during the pandemic.
Conclusion: This study found no evidence of an appreciable rise in the number of complications or delays in systemic anticancer treatment during the COVID-19 pandemic. This experience indicates that systemic chemotherapy may be delivered successfully during a pandemic with infection control and safety precautions. However, more research with a larger sample size is needed for more accurate advice in this case.
Keywords:
- COVID-19 infection
- pandemic
- systemic anticancer therapy
- neutropenia
How to Cite
References
Available:https://www.covid19.who.int
Xia Y, Jin R, Zhao J, et al. Risk of COVID-19 for cancer patients. Lancet Oncol. 2020;21(4):PE180.
DOI: 10.1016/S1470-2045(20)30150-9
Liang W, Guan W, Chen R. Cancer patients in SARS-CoV-2 infection: A nationwide analysis in China. Lancet Oncol. 2020;21:335–337.
Zhang L, Zhu F, Xie L, Wang C, Wang J et al. Clinical characteristics of COVID-19-infected cancer patients: A retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020;31 (7):894-901. Epub 2020 Mar 26.
PMID: 32224151; PMCID: PMC7270947.
DOI: 10.1016/j.annonc.2020.03.296
Lee LY, Cazier JB, Angelis V, Arnold R, Bisht V, et al. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: A prospective cohort study. Lancet. 2020;395(10241): 1919-1926.
DOI: 10.1016/S0140-6736(20)31173-9.
Latif MF, Tirmazy SH, El-Shourbagy D, Basit AQ, Das K, Omara M, et al. Provision of oncology services in Dubai health authority during first wave of COVID-19 pandemic: A pragmatic approach. Middle East J Cancer. 2022;13(4):733-5.
DOI: 10.30476/mejc.2021. 89770.154
Mazzaferro DM, Patel V, Asport N, Stetson RL, Rose D, et al. The financial impact of COVID-19 on a surgical department: The effects of surgical shutdowns and the impact on a health system. Surgery. 2022:S0039-6060(22)00608-0. Epub ahead of print. PMID: 36123177; PMCID: PMC9388446
DOI: 10.1016/j.surg.2022.08.014
American College of Surgeons COVID-19: Guidance for triage of non-emergent surgical procedures; 2020.
Available:https://www.facs.org/covid-19/clinical-guidance/triage
Centers for medicare and medicaid services non-emergent, elective medical services, and treatment recommendations; 2020.
Available:https://www.cms.gov/files/document/cms-non-emergent-elective-medical-recommendations.pdf
Rachel Riera, Ângela Maria Bagattini, Rafael Leite Pacheco, Daniela Vianna Pachito, Felipe Roitberg, Andre Ilbawi. Delays Disruptions In Cancer Health Care Due To Covid-19 Pandemic: Systematic Review. JCO Global Oncology. 2021;7:311-323.
UK office for national statistics characteristics of those dying from COVID-19. Available:https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsinvolvingcovid19englandandwales/deathsoccurringinmarch2020#characteristics-of-those-dying-from-covid-19
Dai MY, Liu D, Liu M. Patients with cancer appear more vulnerable to SARS-CoV-2: A multi center study during the COVID-19 outbreak. Cancer Discov; 2020
Accesson April 28.
DOI: 10.2139/ssrn.3558017
The lancet oncology COVID-19: Global consequences for oncology. Lancet Oncol. 2020;21:467.
Russell B, Moss C, Tsotra E, Gousis C, Josephs D, Enting D et al. The Impact of COVID-19 on the delivery of systemic anti-cancer treatment at guy's cancer centre. Cancers (Basel). 2022;14(2):266. PMID: 35053432; PMCID: PMC8773464.
DOI: 10.3390/cancers14020266
Fitzpatrick O, Ní Dhonaill R, Linehan A, Coyne Z, Hennessy M, Clarke et al. Delivery of systemic anti-cancer therapy during the COVID-19 pandemic. Ir J Med Sci. 2022;191(2):559-562. Epub 2021 May 12. PMID: 33977394; PMCID: PMC8112878.
DOI: 10.1007/s11845-021-02631-1
Dale DC. Colony-stimulating factors for the management of neutropenia in cancer patients. Drugs. 2002;62(Suppl 1):1–15.
Klastersky J, de Naurois J, Rolston K, Rapoport B, Maschmeyer G et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Ann Oncol. 2016;27(Suppl 5):v111–8.
Renner P, Milazzo S, Liu JP, Zwahlen M, Birkmann J, Horneber M. Primary prophylactic colony-stimulating factors for the prevention of chemotherapy-induced febrile neutropenia in breast cancer patients. Cochrane Database Syst Rev. 2012;10:CD007913.
Weycker D, Li X, Edelsberg J, Barron R, Kartashov A, Xu H, et al. Risk and consequences of chemotherapy-induced febrile neutropenia in patients with metastatic solid tumors. J Oncol Pract. 2015;11:47–54
NCCN.org. Myeloid growth factors. In: NCCN guidelines for treatment of Cancer by site. National Comprehensive Cancer Network; 2017.
Available:https://www.nccn.org/professionals/physician_gls/f_guidelines.asp
Toriumi R, Yaegashi H, Kadomoto S, Iwamoto H, Iijima M et al. The COVID-19 pandemic reduced the risk of febrile neutropenia during inpatient chemotherapy for urological cancer. Cancer Sci. 2022:10.1111/cas. 15490.
Epub ahead of print.
PMID: 35838191
PMCID: PMC9349703.
DOI: 10.1111/cas.15490
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