The Impact of COVID-19 on brachytherapy during the pandemic: a Rutgers-Robert Wood Johnson Barnabas Health multi-site experience.

Abstract Purpose /Objectives: To evaluate whether the COVID-19 pandemic resulted in treatment delays in patients scheduled for or undergoing brachytherapy. Materials/Methods A retrospective cohort study was conducted across four affiliated sites following local Institutional Review Board approval. Eligibility criteria were defined as all patients with cancer whose treatment plan included brachytherapy during the COVID-19 pandemic from 2/24/2020 to 6/30/2020. Treatment delays, cancellations, alterations of fractionation regimens and treatment paradigm changes were evaluated. Results A total of 47 patients were eligible for analysis. The median age at time of treatment was 62 (Inter Quartile Range 56-70). Endometrial, cervical and prostate cancers were the most common sites included in this analysis. Three patients (6.4%) with cervical cancer were diagnosed with COVID-19 during the course of their treatment. Interruptions of EBRT, cancellations of EBRT, cancellations of brachytherapy and treatment delays due to COVID occurred in 5 (10.6%), 3 (6.4%), 8 (17%) and 9 (19%) patients, respectively. The mean and median number of days delayed for patients who experienced treatment interruptions were 16.3 days (Std dev=13.9) and 14 days (IQR=5.75-23.75), respectively. For cervical cancer patients, the mean and median overall treatment time defined as time from start of EBRT to end of brachytherapy were 56 and 49 days, respectively. Conclusions Despite the challenges the healthcare system faced during the pandemic, it is reassuring to report that most patients with cancer were safely treated with minor treatment delays and interruptions. Long-term follow-up is needed to assess the impact of COVID-19 and treatment interruptions on oncological outcomes.