COVID-19 salgını sırasında temiz bir onkoloji hastanesinde radyasyon onkolojisi kliniği yönetimi

Öz

Amaç: COVID-19 2020 yılında DSÖ tarafından pandemi olarak ilan edilmiş bir hastalıktır. Türkiye’de ilk vaka 11 Mart 2020’de tespit edilmiştir. Kanser tanısı olan hastaların COVID-19 enfeksiyonu açısından daha riskli olduğu bildirildiğinden onkoloji hastanesi olarak hastanemizde mini bilim kurulu oluşturuldu. Bu bilim kurulunun tavsiyeleri ve yerel yöneticilerin izinleri ile Türkiye’de kanser konusunda uzmanlaşmış tek eğitim ve araştırma hastanesi olan hastanemiz, kanser tedavilerine kesintisiz devam edebilmek için temiz hastane görevini üstlenmiştir. Radyoterapi kanser tedavisinde önemli bir role sahiptir ve hastanemizin radyoterapi kliniği Türkiye’nin en büyük radyoterapi kliniklerinden birisidir. Bu çalışmada, Türkiye’deki temiz bir onkoloji hastanesindeki radyasyon onkolojisi kliniğinin iş akışı incelenerek pandemi gibi özel durumlar için fikir oluşturulması amaçlanmıştır. Yöntemler: Kliniğin iş akışı, alınan önlemler, radyoterapi uygulanan ve radyoterapi sürecinde COVID-19 pozitif tespit edilen hasta sayısı değerlendirilmiştir. Değerlendirme için radyasyon onkolojisi kliniği verileri kullanılmıştır. Bulgular: Bölümümüzde Mart 2020’de 287 hasta, Nisan 2020’de 164 hastaya radyoterapi uygulanmış; bu hastalardan sadece 3 tanesinde COVID-19 pozitifliği tespit edilmiştir. Hiçbir personelimizde COVID-19 pozitifliği saptanmamıştır. Sonuç: Gelecekte ortaya çıkabilecek bu pandemi gibi acil durumlarda kanser tedavilerinin kesintisiz devam edebilmesi için temiz hastanelerin varlığı önemlidir.

Anahtar Kelimeler

• COVID-19
• Pandemi
• Radyasyon onkolojisi

Management of a radiation oncology clinic in a clean oncology hospital during the COVID-19 outbreak

Abstract

Aim: COVID-19 is a disease that was declared a pandemic by the World Health Organization (WHO) in 2020. The first case in Turkey was confirmed on 11 March 2020. Since patients with cancer were reported to have a higher risk for COVID-19 infection, as an oncology hospital, we created a mini science board within our hospital. By following the advice of this science board and the permissions of the local administrators our hospital, which is the only training and research hospital that specialized in oncology in Turkey, undertook the clean hospital mission to continue cancer treatments uninterruptedly. Radiotherapy has an essential role in cancer treatment and our radiotherapy department is the biggest one in Turkey. This retrospective study aimed to constitute ideas for special issues such as pandemics by examining the workflow of our hospital’s radiation oncology clinic. Methods: The workflow of the clinic, the precautions taken, the number of treated patients and the COVID-19 positive cases were evaluated. The records of the radiation oncology clinic were used for evaluation. Results: Two-hundred forty-seven patients in March 2020 and 164 patients in April 2020 were treated in our department. None of our staff and only 3 of our patients were COVID-19 positive. Conclusion: For emergent situations like this pandemic that may occur in the future, the existence of clean hospitals is essential to continue cancer treatments uninterruptedly.

Keywords

• covıd-19
• pandemics
• Radiation oncology

References

1. 1. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. Epub 2020/03/03. doi: 10.1016/j.jaut.2020.102433. PubMed PMID: 32113704; PubMed Central PMCID: PMCPMC7127067.
2. 2. Bassetti M, Vena A, Giacobbe DR. The novel Chinese coronavirus (2019-nCoV) infections: Challenges for fighting the storm. Eur J Clin Invest. 2020;50(3):e13209. Epub 2020/02/01. doi: 10.1111/eci.13209. PubMed PMID: 32003000; PubMed Central PMCID: PMCPMC7163647.
3. 3. Shen K, Yang Y, Wang T, Zhao D, Jiang Y, Jin R, et al. Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts' consensus statement. World J Pediatr. 2020;16(3):223-31. Epub 2020/02/09. doi: 10.1007/s12519-020-00343-7. PubMed PMID: 32034659; PubMed Central PMCID: PMCPMC7090771.
4. 4. Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335-7. Epub 2020/02/19. doi: 10.1016/S1470-2045(20)30096-6. PubMed PMID: 32066541; PubMed Central PMCID: PMCPMC7159000.
5. 5. Combs SE, Belka C, Niyazi M, Corradini S, Pigorsch S, Wilkens J, et al. First statement on preparation for the COVID-19 pandemic in large German Speaking University-based radiation oncology departments. Radiat Oncol. 2020;15(1):74. Epub 2020/04/09. doi: 10.1186/s13014-020-01527-1. PubMed PMID: 32264908; PubMed Central PMCID: PMCPMC7136995.
6. 6. Achard V, Tsoutsou P, Zilli T. Letter from Switzerland. Int J Radiat Oncol Biol Phys. 2020;107(3):600-1. Epub 2020/03/23. doi: 10.1016/j.ijrobp.2020.03.008. PubMed PMID: 32199942; PubMed Central PMCID: PMCPMC7269705.
7. 7. Thomson DJ, Palma D, Guckenberger M, Balermpas P, Beitler JJ, Blanchard P, et al. Practice Recommendations for Risk-Adapted Head and Neck Cancer Radiation Therapy During the COVID-19 Pandemic: An ASTRO-ESTRO Consensus Statement. Int J Radiat Oncol Biol Phys. 2020;107(4):618-27. Epub 2020/04/18. doi: 10.1016/j.ijrobp.2020.04.016. PubMed PMID: 32302681; PubMed Central PMCID: PMCPMC7194855.
8. 8. Guckenberger M, Belka C, Bezjak A, Bradley J, Daly ME, DeRuysscher D, et al. Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: An ESTRO-ASTRO consensus statement. Radiother Oncol. 2020;146:223-9. Epub 2020/04/29. doi: 10.1016/j.radonc.2020.04.001. PubMed PMID: 32342863; PubMed Central PMCID: PMCPMC7252074.

9. 9. Gemici C, Yaprak G. Covid-19 outbreak in a major radiation oncology department; which lessons should be taken? Radiother Oncol. 2020;149:107-8. Epub 2020/04/29. doi: 10.1016/j.radonc.2020.03.044. PubMed PMID: 32342865; PubMed Central PMCID: PMCPMC7194801.
10. 10. Meattini I, Franco P, Belgioia L, Boldrini L, Botticella A, De Santis MC, et al. Radiation therapy during the coronavirus disease 2019 (covid-19) pandemic in Italy: a view of the nation's young oncologists. ESMO Open. 2020;5(2). Epub 2020/04/17. doi: 10.1136/esmoopen-2020-000779. PubMed PMID: 32295769; PubMed Central PMCID: PMCPMC7199912.
11. 11. Cesari M, Proietti M. Editorial: Geriatric medicine in Italy in the time of COVID-19. J Nutr Health Aging. 2020;24(5):459-60. Epub 2020/04/30. doi: 10.1007/s12603-020-1354-z. PubMed PMID: 32346679; PubMed Central PMCID: PMCPMC7118363.
12. 12. Bese NS, Hendry J, Jeremic B. Effects of prolongation of overall treatment time due to unplanned interruptions during radiotherapy of different tumor sites and practical methods for compensation. Int J Radiat Oncol Biol Phys. 2007;68(3):654-61. Epub 2007/05/01. doi: 10.1016/j.ijrobp.2007.03.010. PubMed PMID: 17467926.