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http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/3970
Breast radiotherapy under COVID-19 pandemic resource constraints -- approaches to defer or shorten treatment from a Comprehensive Cancer Center in the United States | |
Braunstein Lior Z. Gillespie Erin F. Hong Linda. Xu Amy. Bakhoum Samuel F. Cuaron John. Mueller Boris. McCormick Beryl. Cahlon Oren. Powell Simon. Khan Atif J. | |
Acceso Abierto | |
Atribución-NoComercial-SinDerivadas | |
10.1016/j.adro.2020.03.013 | |
Introduction:Breast radiotherapy accounts for a significant proportion of patient volume in contemporary radiation oncology practice. In the setting of anticipated resource constraints and widespread community infection with SARS-CoV-2 during the COVID-19 pandemic, measures for balancing both infectious and oncologic risk among patients and providers must be carefully considered. Here, we present evidence-based guidelines for omitting or abbreviating breast cancer radiotherapy, where appropriate, in an effort to mitigate risk to patients and optimize resource utilization. Methods:Multidisciplinary breast cancer experts at a high-volume comprehensive cancer center convened contingency planning meetings over the early days of the COVID-19 pandemic to review the relevant literature and establish recommendations for the application of hypofractionated and abbreviated breast radiation regimens. Results:Substantial evidence exists to support omitting radiation among certain favorable risk subgroups of breast cancer patients and for abbreviating or accelerating regimens among others. For those who require either whole-breast or post-mastectomy radiation, with or without coverage of the regional lymph nodes, a growing body of literature supports various hypofractionated approaches that appear safe and effective. Conclusion:In the setting of a public health emergency with the potential to strain critical healthcare resources and place patients at infection risk, the parsimonious application of breast radiotherapy may alleviate a significant clinical burden without compromising long term oncologic outcomes. The judicious and personalized use of immature study data may be warranted in the setting of a competing mortality risk from this widespread pandemic. | |
Advances in Radiation Oncology | |
2020 | |
Artículo | |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118660/pdf/main.pdf | |
Inglés | |
VIRUS RESPIRATORIOS | |
Aparece en las colecciones: | Artículos científicos |
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