For cancer sufferers receiving radiation therapy throughout a surge in COVID-19 circumstances, adhering to the stay-at-home orders of quarantine isn’t at all times an possibility. The each day hospital journeys probably improve publicity, which is very harmful as a result of cancer sufferers are at excessive threat for COVID-19 mortality. The choice to delay radiation therapy till COVID-19 circumstances flatten may assist cancer sufferers reduce publicity to the virus by staying dwelling. A brand new examine by investigators from Brigham and Women’s Hospital discovered that for males with unfavorable intermediate-risk or high-risk localized prostate cancer, who’re receiving radiation and hormone therapy, delaying radiation whereas remaining on hormone therapy is unlikely to influence survival. Their outcomes are revealed in JAMA Oncology.
“Using a large database of patients with prostate cancer, we validated that the timing of starting radiation could be flexible,” stated Vinayak Muralidhar, MD, a resident in the Department of Radiation Oncology on the Brigham. “Our data suggest that patients can wait for COVID-19 cases to go down before starting radiation. Or, if there’s a chance a surge is coming, they could consider undergoing radiation a little earlier than planned and complete it before the surge arrives.”
“Our hope is that our study helps patients and providers make decisions about the timing of treatment,” stated Edward Christopher Dee, a fourth-year pupil at Harvard Medical School who was the primary creator of the examine. “These decisions may allow patients to decrease their risk of exposure to COVID-19. Our findings may also provide reassurance to patients and providers who choose to delay treatment.”
Radiation therapy is used for sufferers with localized prostate cancer and is given with 6-to-36 months of androgen deprivation therapy, or hormone therapy. Based on preclinical information, these two kinds of therapy are sometimes timed in order that sufferers obtain radiation treatment after two months of hormone therapy. However, two trials this sequence of therapy confirmed that inside a small window, precise timing of beginning radiation relative to beginning hormone therapy didn’t have an effect on the end result. The Brigham investigators needed to validate the findings of those two comparatively small trials in a cohort of over 63,000 circumstances of localized prostate cancer in the National Cancer Database. With this kind of information set, the staff acknowledges there may very well be unmeasured variations between the sufferers that weren’t accounted for however clarify the findings.
The circumstances had been separated into 4 teams based mostly on when radiation was began relative to hormone therapy. For circumstances of intermediate and high-risk illness, there was no distinction in total survival among the many 4 teams.
“The findings are reassuring to patients and allow us to come up with a flexible radiation schedule for prostate cancer that ensures their safety,” stated Muralidhar. “The results have important implications for patients in areas experiencing a surge in COVID-19 cases who can opt to wait for a safer time to come in and initiate treatment. In the future, we can also look at other types of cancers and treatments and see how delaying therapy has an impact on survival.”
Dee, EC et al. “Timing of Radiation and Androgen Deprivation for Prostate Cancer: Implications for Treatment during the COVID-19 Pandemic” JAMA Oncology DOI: 10.1001/jamaoncol.2020.3545
Brigham and Women’s Hospital
Delaying prostate cancer radiation therapy offers room for flexibility in pandemic peak (2020, August 13)
retrieved 13 August 2020
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