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COVID-19 and radiotherapy: how to continue care?


Just like the other departments at Institut Curie that welcome patients, the Department of oncological radiotherapy has had to implement a certain number of measures to ensure continuity of care for its patients and their protection, as well as that of its staff. Interview with Gilles Créhange, Head of our oncological radiotherapy department.

Gilles Crehange

What does the coronavirus pandemic mean for the treatment of patients with cancer?

Although radiotherapy is administered to a majority of patients in an outpatient setting, our priority during the crisis is to postpone any non-urgent treatment (breast, prostate) and reduce the number of radiotherapy sessions, while guaranteeing the approved nationally or internationally approved therapeutic standards. We need to review radiotherapy in a fundamental way.

What is the role of the Department of oncological radiotherapy within this current crisis?

More than two thirds of cancer patients will require radiotherapy treatment during their course of care. This treatment is often part of a multimodal treatment approach with a curative aim. In some tumors, exclusive radiotherapy can be curative (prostate cancer, ENT cancers, bladder cancer, esophageal or localized lung cancers). In high-risk patients, within the context of the COVID-19 pandemic, this treatment may also be an alternative to certain surgery options, thus avoiding hospitalization. Our priorities are as follows:

  1. To ensure optimized continuity of care in oncology to prevent lost opportunities for our patients.

  2. To reduce circulation of the virus at Institut Curie.
  3. To physically and psychologically protect our healthcare teams as best we can.

Are there risks involved in continuing radiotherapy treatment when infected with the coronavirus?

There are known interactions between a coronavirus infection and radiotherapy which could be harmful. The risk remains that of exposure to the virus at each hospital admission, during each round-trip journey via public transportation or in the street, when attending radiotherapy sessions every day.

How can we reassure patients at Institut Curie on this matter?

Patients can be reassured about the procedures currently implemented in our department. All of these measures, although at times restrictive, are designed to protect them, as well as our staff, using adapted channels and special treatment techniques that respect these channels.

We have set up 3 treatment channels: a dedicated machine for treating patients with COVID-19 at the Paris site, and two separate channels on the three sites for COVID negative or suspected COVID patients.

The treatments are currently administered using techniques that may be adapted, as quickly as possible depending on their pathology. Some pathologies can however be delayed by several weeks, if there is no progression or if there is a related treatment (related hormone treatment for example) allowing treatment to be delayed without worry. Our concern and our priority every day during this health crisis is to guarantee the best care for our patients, and to prevent them from being needlessly infected, as far as possible.

How did you manage this?

Information explaining this exceptional organization has been circulated to all treatment stations and sent to all patients awaiting treatment. The pace of consultations has been slowed down with filtering by handlers during the session and weekly phone calls to assess needs in consultation. As in the other departments at Institut Curie, a remote consultation is carried out whenever possible and required to avoid travel. Our priority is to reassure patients about their care, helping to organize their treatment during the confinement period, or at the end of the confinement period.