Uticaj Covid-19 na radioterapiju u Republici Srpskoj
Sažetak
Uvod/Cilj. Bolest prouzrokovana koronavirusom 2019 (coronavirus disease 19 ‒ COVID-19) utiče na bolesnike sa bilo kojim tipom hronične bolesti, a posebno na one sa malignitetima. Cilj studije bio je da se utvrdi uticaj pandemije COVID-19 na broj nedeljnih frakcija radioterapije (RT) sa spoljašnjim zračenjem (EBRT) i mesečne brahiterapijske (BT) aplikacije, bez namernog hipofrakcionisanja, kao i njen uticaj na broj bolesnika podvrgnutih EBRT, mlađih ili starijih od 70 godina. Metode. Centar za radioterapiju Affidea u Banjoj Luci (BL RT centar), pruža RT stanovništvu (1,15 miliona) Republike Srpske (Bosna i Hercegovina). Analizirali smo period od 14 meseci pre početka COVID-19 i isti period za vreme COVID-19. Rezultati. Prosečni sedmični broj EBRT frakcija u periodu od januara 2019. do kraja februara 2020. iznosio je 680,5 [standardna devijacija (SD) 67,4], a od marta 2020. do kraja aprila 2021, 617,1 (SD 96,4). Tokom aprila 2020., sedmični broj EBRT frakcija smanjio se 67,9% u odnosu na isti period 2019., dok je u martu 2021. godine pao za 42,4%; t-test uparenih uzoraka pokazao je da je pojava pandemije COVID-19 imala statistički značajan učinak [t (60) = 4.627, p < 0,05], na smanjenje broja sedmičnih EBRT frakcija u BL RT centru. Smanjenje broja bolesnika podvrgnutih EBRT starijih od 70 godina u odnosu na mlađe od 70 godina, iznosilo je 16,3% naspram 1,6%, redom. Wilcoxon rang test otkrio je da je pandemija COVID-19 imala statistički značajan učinak na smanjenje broja mesečnih BT aplikacija (Z = -2,42, p = 0,016). Zaključak. Za prvih 14 meseci pandemije primećen je statistički značajan pad EBRT i BT u BL RT centru. „Talasi“ pandemije „zatvarali“ su odeljenja potrebna za dijagnostiku i terapiju onkoloških bolesnika i pretvarali ih u COVID-19 odeljenja. Zbog toga pojedini onkološki bolesnici nikada nisu dobili RT koja im je bila indikovana.
Reference
Mayor S. COVID-19: Impact on cancer workforce and deliv-ery of care. Lancet Oncol 2020; 21(5): 633.
Royal College of Radiologists. Coronavirus (COVID-19): cancer treatment documents. Available from: https://www.rcr.ac.uk/college/coronavirus covid-19-what-rcr-doing/clinical-information/coronavirus-covid-19- cancer [accessed September 2020].
In WHO global pulse survey, 90% of countries report disrup-tions to essential health services since COVID-19 pandemic. Geneva: World Health Organization; 2020.
Spencer K, Jones CM, Girdler R, Roe C, Sharpe M, Lawton S, et al. The impact of the COVID-19 pandemic on radiotherapy services in England, UK: a population-based study. Lancet Oncol 2021; 22(3): 309–20.
Sud A, Jones ME, Broggio J, Loveday C, Torr B, Garrett A, et al. Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic. Ann Oncol 2020; 31(8): 1065–74.
Martinez D, Sarria GJ, Wakefield D, Flores C, Malhotra S, Li B, et al. COVID's Impact on Radiation Oncology: A Latin Amer-ican Survey Study. Int J Radiat Oncol Biol Phys 2020; 108(2): 374–8.
Analysis of Population Health in Republic of Srpska, 2016. Republic of Srpska, Banja Luka; Institute of Public Health; 2016.
Pallant J. SPSS Survival Manual: A Step by Step Guide to Da-ta Analysis Using IBM SPSS. 7th ed. London: Routledge; 2020.
Chauhan R, Trivedi V, Rani R, Singh U, Singh V, Shubham S, et al. The impact of COVID-19 pandemic on the practice of ra-diotherapy: A retrospective single-institution study. Cancer Res Stat Treat 2020; 3(3): 467‒74.
Nierengarten MB. ASTRO survey details effects of COVID-19 on radiation oncology. Cancer 2021; 127(16): 2827.
ASTRO. COVID-19’s Impact on Radiation Oncology: Initial Results of a Nationwide Physician Survey. Arlington, VA: ASTRO American Society for Radiation Oncology; 2020.
Achard V, Aebersold DM, Allal AS, Andratschke N, Baumert BG, Beer KT, et al. A national survey on radiation oncology patterns of practice in Switzerland during the COVID-19 pandemic: present changes and future perspectives. Radiother Oncol 2020; 150: 1–3.
Gonnelli A, Montrone S, Cocuzza P, Ursino S, Manfredi B, Mattioni R, et al. Radiotherapy in the COVID-19 Pandemic Era. In Vivo 2020; 34(6): 3731‒4.
Amador M, Matias Guiu X, Sancho Pardo G, Contreras Martinez J, de la Torre-Montero JC, Penuelas Saiz A, et al. Impact of the COVID-19 pandemic on the care of cancer patients in Spain. ESMO Open 2021; 6(3): 100157.
Carvalho HA, Vasconcelos KGMC, Gomes HC, Salvajoli JV. Im-pact of COVID-19 pandemic on a daily-based outpatient treatment routine: experience of a radiotherapy department of a tertiary public/university hospital in Brazil. Clinics (Sao Paulo) 2020; 75: e2298.
He J, Yang L, Tao Z, Yang J, Zhou Y, Wang R, et al. Impact of the 2019 Novel Coronavirus Disease (COVID-19) Epidemic on Radiotherapy-Treated Patients with Cancer: A Single-Center Descriptive Study. Cancer Manag Res 2021; 13: 37‒43.
Vaandering A, Ben Mustapha S, Lambrecht M, Van Gestel D, Veldmeman L. Impact of the COVID-19 Pandemic on Pa-tients and Staff in Radiation Oncology. Front. Oncol 2021; 11: 654086.