Daily hospital trips for radiation treatment pose a potential virus exposure danger for patients with cancer, who are at high risk of COVID‐19 mortality, experts say. Delaying radiation therapy until virus cases flatten could be a useful option as long as the delay does not affect a patient’s cancer. In the study, researchers from Brigham and Women’s Hospital in Boston found that radiation therapy delays are unlikely to affect survival for men with unfavorable, intermediate‐risk or high‐risk, localized prostate cancer who are receiving hormone therapy.
Investigators analyzed a large database of patients with prostate cancer and validated that the starting time of radiation could be flexible, and this could enable patients to wait for COVID‐19 case numbers to decline before beginning therapy. Conversely, according to the authors, if a surge is anticipated, radiation could begin earlier than planned and be completed before the surge occurs.
Patients who have localized prostate cancer receive radiation along with 6 to 36 months of androgen deprivation therapy; radiation therapy typically begins 2 months after hormone therapy. Two previous trials showed that within a small window, however, the exact timing of starting radiation with respect to starting hormone therapy did not affect outcomes.
The Brigham study was an effort to validate the findings of these 2 small trials by analyzing a cohort of more than 63,000 localized prostate cancer cases from the National Cancer Database. Separating cases into 4 groups according to when radiation was started with respect to hormone therapy, researchers observed no difference in overall survival for intermediate‐ and high‐risk disease.
The finding that more flexible radiation schedules can be developed to lessen COVID‐19 exposure risks should be reassuring to both patients and clinicians according to coauthor Vinayak Muralidhar, MD, a resident in the Brigham Department of Radiation Oncology. The researchers next plan to assess the effects of therapy delays for other types of cancers and treatments.
Published at Fri, 08 Jan 2021 05:48:45 +0000