Management of locally advanced rectal cancer during the COVID-19 pandemic: A necessary paradigm change at Memorial Sloan Kettering Cancer Center Editorial

   


Authors: Romesser, P. B.; Wu, A. J.; Cercek, A.; Smith, J. J.; Weiser, M.; Saltz, L.; Garcia-Aguilar, J.; Crane, C. H.
Title: Management of locally advanced rectal cancer during the COVID-19 pandemic: A necessary paradigm change at Memorial Sloan Kettering Cancer Center
Abstract: The COVID-19 pandemic will consume significant health care resources. Given the concerns for rapidly increasing infection rates in the United States, impending staffing shortages, and the potential for resource reallocation, we rapidly reevaluated our rectal cancer practice policies during this public health emergency. Before the pandemic, we commonly used total neoadjuvant therapy with a strong preference for long-course chemoradiation. In the setting of the ongoing pandemic, we now mandate short-course radiation therapy (SCRT). Despite multiple randomized trials demonstrating no difference in locoregional recurrence, distant recurrence, or overall survival between SCRT and long-course chemoradiation, the adaptation of SCRT in the United States has been low given concerns for less tumor downstaging and increased toxicity. In the setting of the ongoing and likely prolonged COVID-19 pandemic, we feel that these concerns must be reevaluated, because SCRT presents a well-validated alternative that will allow us to meet the needs of a greater number of potentially curable patients at a time when resources are severely and acutely constrained. © 2020 The Author(s)
Keywords: cancer survival; overall survival; intensity modulated radiation therapy; advanced cancer; capecitabine; neoadjuvant therapy; cancer therapy; cost effectiveness analysis; cancer center; radiation dose fractionation; rectum cancer; chemoradiotherapy; induction chemotherapy; conformal radiotherapy; short course therapy; pandemic; local recurrence free survival; cancer prognosis; human; priority journal; article; distant recurrence free survival; coronavirus disease 2019; short course radiation therapy
Journal Title: Advances in Radiation Oncology
Volume: 5
Issue: 4
ISSN: 2452-1094
Publisher: Elsevier Inc.  
Date Published: 2020-07-01
Start Page: 687
End Page: 689
Language: English
DOI: 10.1016/j.adro.2020.04.011
PROVIDER: scopus
PMCID: PMC7175910
PUBMED: 32322758
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85084983476&doi=10.1016%2fj.adro.2020.04.011&partnerID=40&md5=61ed3012601103e55f0e84c0303e0bf8
Notes: Article -- Export Date: 1 September 2020 -- Source: Scopus
Altmetric
What is Altmetric?
Citation Impact
What is Dimensions Citation Badge?
BMJ Impact Analytics
MSK Authors
  1. Leonard B Saltz
    791 Saltz
  2. Andrea Cercek Hanjis
    353 Cercek Hanjis
  3. Martin R Weiser
    538 Weiser
  4. Abraham Jing-Ching Wu
    401 Wu
  5. Julio Garcia Aguilar
    350 Garcia Aguilar
  6. Paul Bernard Romesser
    192 Romesser
  7. Jesse Joshua Smith
    221 Smith
  8. Christopher Crane
    202 Crane
Related MSK Work