Rationalizing Treatment for Gynecological Cancers During the COVID-19 Pandemic: An Indian Experience
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ORIGINAL ARTICLE
Rationalizing Treatment for Gynecological Cancers During the COVID19 Pandemic: An Indian Experience G. Y. Srinivasa1 Ankita Gupta1
Treshita Dey1 Bhavana Rai1
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Vanita Suri2 • Rashmi Bagga2 • Vanita Jain2 • Sandeep Gadela1 Sakshi Rana1 • Sushmita Ghoshal1 •
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Received: 25 May 2020 / Revised: 27 July 2020 / Accepted: 17 August 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Purpose The entire world is currently facing a devastating crisis due to growing coronavirus pandemic, which was declared as a public health emergency by the World Health Organization on March 11, 2020. Management of cancer patients at this time is an overwhelming task. This study highlights our experience in the management of patients of gynecological malignancies over a period of 2 months during the COVID-19 pandemic. Methods Patients of confirmed gynecological malignancies who visited our outpatient clinic and those who received radiotherapy/chemotherapy in March and April 2020 were included for analysis. Guidelines issued by the National Institute of Health and Care Excellence, National Health Service, MD Anderson Cancer Centre and those by young oncologists in Italy were followed with minor modifications while managing the logistics and health worker safety. Results A total of 160 patients were treated in our department during this time period. In total, 44.4% of patients on treatment had associated comorbidities that imposed an additional risk. One hundred twenty-three patients continued treatment with their initial plan of radiotherapy or chemotherapy. New patients were prioritized based on the severity of clinical symptoms and whether the expected outcome would significantly affect their survival and quality of life. Patients were monitored for the development of treatment-related toxicities and COVID-19-related symptoms. Conclusions All oncology personnel need to identify the correct balance between risks and benefit and then proceed with further management. Thus, it is essential to cautiously select patients for treatment, minimizing the risk of exposure but adequately addressing the underlying disease. Keywords COVID-19 Gynecological malignancies Radiotherapy Chemotherapy Brachytherapy
Introduction The entire world is currently facing a devastating crisis due to growing coronavirus (COVID19) pandemic, which was declared as a public health emergency by the World Health Organization on March 11, 2020. The USA, Spain and Italy have been the worst affected nations to date [1]. The
& Bhavana Rai [email protected] 1
Department of Radiotherapy and Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
situation is no better in India, over 6.25 lakh confirmed cases with 18.2 thousand deaths [2]. Various strategies have been implemented to control the spread of this disease, and this has tremendously affected the healthcar
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