Radiotherapy department reorganization during the COVD-19 outbreak: keys to securing staff and patients during the first weeks of the crisis and impact on radiotherapy practice from a single institution experience.

Belkacemi, Yazid; Krichenane, Gokoula Loaganadane; Grellier, Noémie; Fonteneau, Gloria; Zaoui, Gaël; Coraggio, Gabriele; Hadhri, Asma; Adou, Marie; Bendavid, Jerôme; Boros, Angela; Ghit, Sahar; Debbi, Kamel; Cadot, Pauline; Bak, Adeline; Le bret, Cindy; Hassani, Wissal; Mahé, Mathilde; Hervé, Marie-Laure; Colson-Durand, Laurianne; Hanh TO, Nhu; Luo, Deng feng; Cherif, Aziz

INTRODUCTION: During the first weeks of coronavirus 2019 (COVID-19) outbreak in France, it was necessary to clearly define the organizational priorities in the radiotherapy (RT) departments. In this report, we focus on the urgent measures taken to reduce risk for our staff and for patients by reducing the number of patients on treatment. MATERIALS AND METHODS: We reviewed the fractionation schemes for all patients in our department, including those on treatment and those soon to start treatment. Our goal was to decrease the number of patients coming daily to the hospital for RT and adapt our human resources to continue patients’ care in the department and help to cover understaffed COVID-19 sectors of the hospital. RESULTS: We identified 50 patients who were on treatment (n=6) or were going to start radiation soon as the CT scan simulation has been performed (n=41) and those for whom the CT scan was pending (n=3). The majority were women (64%) treated for breast cancer (54%). RT was delayed for 22 (44%). The majority were offered hormonal therapy as “waiting therapy”. Hypofractionation was considered in 21 (42%) patients with mainly breast cancer patients (18/21, 86%). The number of courses initially planned and re-planned due to the COVID-19 outbreak during the period March 15-May 31, 2020, were 1383 and 683, which represented a reduction of 50% (including delayed sessions) that allowed our reorganization process. CONCLUSION: To conserve resources during the pandemic, we successfully cut down on the number of patients on treatment in a proactive fashion and adapted our organization to minimize the risk of COVID-19 contaminations. Departments across the world may benefit from this same approach.