Session Item

Hypofractionated radiotherapy (HRT) is becoming a valid option in the treatment of different tumours such as breast and rectal cancers. The COVID-19 pandemic brought unprecedented changes to the world. To limit congestion and the risk of exposure, one of the solutions proposed by radiotherapy societies is to generalize the use of HRT in the different radiotherapy departments. The purpose of our study was to evaluate the impact of HRT on the management of breast and rectal cancers in our radiotherapy department before and after the COVID-19 pandemic.

This is a descriptive and comparative study that included all requests for curative treatment by external radiotherapy (RT) for breast and rectal cancers in our department between January 2019 and December 2020.  We collected data related to patients, disease, associated treatments and RT. The RT delay from the last treatment received (LTR) or from the date of histological diagnosis (D) (if no treatment was indicated before RT) (LTR/D-T) was calculated. A comparison of the data of breast and rectal cancer RT requests was carried out between 2 periods: pre-pandemic COVID-19 (January-December 2019) "P1" and COVID-19 pandemic (January-December 2020) " P2 ". The comparison concerned the use of HRT between the 2 periods. Data analysis was performed using SPSS version 20.

During the period of this study, we totalized 780 RT requests (breast: n=669; rectum: n=111), of which 407 during "P1" (breast: n=360; rectum: n=47) and 373 during "P2" (breast: n=309; rectum: n=64). The indication of RT was retained for 729 patients (93.5%) (breast: n=631; rectum: n=98). The simulation was canceled in 102 cases (66: P1; 36: P2). A total of 298 and 254 patients with breast cancer and 29 and 46 patients with rectal cancer were included for analysis in P1 and P2 respectively.

For breast cancer ,118 patients (40%) were treated with HRT and 178 patients (60%) with standard RT (SRT) during P1 versus 244 patients (96.4%) and 9 patients (3.6%) respectively during P2. The difference was statistically significant (p10^-3).

For rectal cancer, 9 patients (32%) were treated with HRT and 19 (68%) with SRT during P1 versus 39 patients (90.6%) and 4 patients (9.4%) respectively during P2. The difference was statistically significant (p10^-3).

The LTR-T mean delay, for rectal cancer, was 3.2 ± 1.4 months [1-7 months] and 2.2± 1.5 months [0-7] respectively in SRT and HRT. The difference was statistically significant (p=0.02). For breast cancer, the LTR-T mean delay was 4 ± 2.1 months [0-12] and 3.6 ± 2.8 months [0-14] respectively in SRT and HRT. The difference was statistically significant (p=0.042).

The results of this study show a significant increase in the use of hypo-fractionated regimens in our department. The reduction in the number of RT sessions contributed to the well management of the crisis during the COVID-19 pandemic with a significant improvement in RT delays.