LAUSR

Purpose or Objective: COVID-19 pandemic has disrupted radiation oncology practices at many treatment sites. However, in line with ESTRO and ESMO statements efforts are needed to prevent delays or interruptions in RT for patients who would risk significantly worse outcome in survival or quality of life (e.g. metastatic spinal cord compression, head&neck cancer patients during definitive chemoradiation, etc.). At the same time risks of complications due to SARS-CoV2 infection had to be carefully considered in order to not causing additional harm to the patient as well as to the staff. Materials and Methods: Protocol for RT was developed and implemented at our department to ensure timely treatment of high priority SARS-CoV2-positive patients (Figure 1). Under strict safety measures, asymptomatic and mild symptomatic patients were eligible to continue with the already started or planned treatment on two designated linacs after normal working hours. Patients were cautiously monitored for early recognition of covid-related complications. (Figure Presented) Results: In total 2,350 patients were treated at out department during the 2nd pandemic wave (October 1 2020- February 28 2021), out of which 15 SARS-CoV2-positive cancer patients underwent RT in active phase of infection (Table 1). Three patients developed covid-related complications that needed longer interruption of RT, one of them was admitted to the ICU and later died from covid pneumonia. In 11 patients that were tested covid positive before the initiation of RT treatment was postponed (in average 12 days, range 7–28 days). No transmission of virus from infected patients to staff members were observed. (Table Presented) Conclusion: In our experience, with significant organisational effort, irradiation of a limited number of well selected SARSCoV2- positive cancer patients is safe and manageable. Nevertheless, due to possible complications overall treatment time can be prolonged.