Prostate cancer radiotherapy recommendations (based on searches in March 2020)
Citation: Zaorsky NG, James BY, McBride SM, Dess RT, Jackson WC, Mahal BA, Chen R, Choudhury A, Henry A, Syndikus I, Mitin T. Prostate cancer radiotherapy recommendations in response to COVID-19. Advances in Radiation Oncology. 2020;5(4):659-65.
What is this? The COVID-19 pandemic has had an impact on the care of cancer patients. Guidance and recommendations for the management of, for example, prostate cancer radiation therapy during the pandemic might provide useful information for healthcare providers and policy makers.
In their rapid review, the authors searched for systematic reviews, national guidelines and randomized trials of radiation therapy for prostate cancer in patients not infected with COVID-19 to develop a framework for management of prostate cancer treatment in the context of the COVID-19 pandemic. They restricted their searches to articles published in English between January 1990 and March 2020, and provided recommendations based on the review.
What was found: At the time of this review, the authors suggest that resources can be reduced for all stages of prostate cancer during the pandemic, recommending remote visits, avoidance, deferment, and shortening of radiation therapy depending on patient’s level of risk.
At the time of this review, the authors suggest that early salvage radiation therapy is preferable to adjuvant radiation therapy during the pandemic and that when radiation therapy is necessary, the shortest fractionation schedule supported by evidence of efficacy and safety should be implemented.
At the time of this review, the authors suggest that brachytherapy should be avoided during the peak of the pandemic, unless it can be performed with local anesthesia.