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- Title
How the COVID-19 Pandemic Impacted on Integrated Care Pathways for Lung Cancer: The Parallel Experience of a COVID-Spared and a COVID-Dedicated Center.
- Authors
Pasello, Giulia; Menis, Jessica; Pilotto, Sara; Frega, Stefano; Belluomini, Lorenzo; Pezzuto, Federica; Caliò, Anna; Sepulcri, Matteo; Cernusco, Nunzia Luna Valentina; Schiavon, Marco; Infante, Maurizio Valentino; Damin, Marco; Micheletto, Claudio; Del Bianco, Paola; Giovannetti, Riccardo; Bonanno, Laura; Fantoni, Umberto; Guarneri, Valentina; Calabrese, Fiorella; Rea, Federico
- Abstract
Introduction: The COVID-19 pandemic has proved to be a historic challenge for healthcare systems, particularly with regard to cancer patients. So far, very limited data have been presented on the impact on integrated care pathways (ICPs). Methods: We reviewed the ICPs of lung cancer patients who accessed the Veneto Institute of Oncology (IOV)/University Hospital of Padua (Center 1) and the University Hospital of Verona (Center 2) before and after the COVID-19 pandemic, through sixteen indicators chosen by the members of a multidisciplinary team (MDT). Results: Two window periods (March and April 2019 and 2020) were chosen for comparison. Endoscopic diagnostic procedures and major resections for early stage NSCLC patients increased at Center 1, where a priority pathway with dedicated personnel was established for cancer patients. A slight decrease was observed at Center 2 which became part of the COVID unit. Personnel shortage and different processing methods of tumor samples determined a slightly longer time for diagnostic pathway completion at both Centers. Personnel protection strategies led to a MDT reshape on a web basis and to a significant selection of cases to be discussed in both Centers. The optimization of patient access to healthcare units reduced first outpatient oncological visits, patient enrollment in clinical trials, and end-of-life cancer systemic treatments; finally, a higher proportion of hypofractionation was delivered as a radiotherapy approach for early stage and locally advanced NSCLC. Conclusions: Based on the experience of the two Centers, we identified the key steps in ICP that were impacted by the COVID-19 pandemic so as to proactively put in place a robust service provision of thoracic oncology.
- Subjects
VERONA (Italy); COVID-19 pandemic; LUNG cancer; INTEGRATIVE medicine; HYPOPHARYNGEAL cancer; HEALTH services accessibility; COVID-19; ONCOLOGY nursing; ONCOLOGISTS
- Publication
Frontiers in Oncology, 2021, Vol 11, p1
- ISSN
2234-943X
- Publication type
Article
- DOI
10.3389/fonc.2021.669786