tetano
Editor, Senior Moderator
Int J Radiat Oncol Biol Phys
. 2021 Feb 17;S0360-3016(21)00197-8.
doi: 10.1016/j.ijrobp.2021.02.022. Online ahead of print.
Systematic screening of COVID-19 disease based on chest CT and RT-PCR for cancer patients undergoing radiotherapy in a coronavirus French hotspot
Roger Sun[SUP] 1 [/SUP], Samir Achkar[SUP] 2 [/SUP], Samy Ammari[SUP] 3 [/SUP], Sophie Bockel[SUP] 2 [/SUP], Emmanuelle Gallois[SUP] 4 [/SUP], Arnaud Bayle[SUP] 5 [/SUP], Enzo Battistella[SUP] 6 [/SUP], Flore Salviat[SUP] 7 [/SUP], Mansouria Merad[SUP] 5 [/SUP], Adrien Laville[SUP] 2 [/SUP], Kanta Ka[SUP] 2 [/SUP], Franck Griscelli[SUP] 4 [/SUP], Laurence Albiges[SUP] 5 [/SUP], Fabrice Barlesi[SUP] 5 [/SUP], Alberto Bossi[SUP] 2 [/SUP], Sofia Rivera[SUP] 2 [/SUP], Cyrus Chargari[SUP] 1 [/SUP], Eric Deutsch[SUP] 8 [/SUP]
Affiliations
Abstract
Background: Cancer patients are presumed to be more vulnerable to COVID-19. We evaluated a screening strategy combining chest computed-tomography (CT) and reverse transcription polymerase chain reaction (RT-PCR) for patients treated with radiotherapy (RT) in our cancer center located in a COVID-19 French hotspot during the first wave of the pandemic.
Methods: Chest CT images were proposed during the radiotherapy CT simulation. Images were reviewed by an expert radiologist according to the CO-RADS classification. Nasal swabs with RT PCR assay were initially proposed in case of suspicious imaging or clinical context and were eventually integrated into the systematic screening. A dedicated radiotherapy workflow was proposed for COVID-19 patients to limit the risk of contamination.
Results: From March 18, 2020 to May 1, 2020, 480 patients were screened by chest CT, with 313 patients having both chest CT and RT-PCR (65%). Cumulative incidence of COVID-19 was 5.4%, 95%CI [3.6, 7.8] (26 patients out of 480). Diagnosis of COVID-19 was made before RT for 22 patients (84.6%) and during RT for 4 patients (15.3%). Chest CT directly aided the diagnosis of 7 cases for whom the initial RT-PCR was negative or not feasible; out of a total of 480 patients (1.5%) and 517 chest CT acquisition. Four patients with COVID-19 at the time of the chest CT screening had a false negative CT. Sensitivity and specificity of chest CT screening in patients with both RT-PCR and chest CT testing were estimated to be 0.82, 95% CI [0.60, 0.95] and 0.98, 95% CI [0.96, 0.99] respectively.Adaptation of the radiotherapy treatment was made for all the patients with seven postponed treatments (median=5 days, IQR [1.5, 14.8]).
Conclusion: The benefit of systematic use of chest CT screening during CT simulation for patients undergoing radiotherapy during the COVID-19 pandemic seemed limited.
Keywords: COVID-19; SARS-CoV-2; cancer; radiotherapy; screening.
. 2021 Feb 17;S0360-3016(21)00197-8.
doi: 10.1016/j.ijrobp.2021.02.022. Online ahead of print.
Systematic screening of COVID-19 disease based on chest CT and RT-PCR for cancer patients undergoing radiotherapy in a coronavirus French hotspot
Roger Sun[SUP] 1 [/SUP], Samir Achkar[SUP] 2 [/SUP], Samy Ammari[SUP] 3 [/SUP], Sophie Bockel[SUP] 2 [/SUP], Emmanuelle Gallois[SUP] 4 [/SUP], Arnaud Bayle[SUP] 5 [/SUP], Enzo Battistella[SUP] 6 [/SUP], Flore Salviat[SUP] 7 [/SUP], Mansouria Merad[SUP] 5 [/SUP], Adrien Laville[SUP] 2 [/SUP], Kanta Ka[SUP] 2 [/SUP], Franck Griscelli[SUP] 4 [/SUP], Laurence Albiges[SUP] 5 [/SUP], Fabrice Barlesi[SUP] 5 [/SUP], Alberto Bossi[SUP] 2 [/SUP], Sofia Rivera[SUP] 2 [/SUP], Cyrus Chargari[SUP] 1 [/SUP], Eric Deutsch[SUP] 8 [/SUP]
Affiliations
- PMID: 33609591
- DOI: 10.1016/j.ijrobp.2021.02.022
Abstract
Background: Cancer patients are presumed to be more vulnerable to COVID-19. We evaluated a screening strategy combining chest computed-tomography (CT) and reverse transcription polymerase chain reaction (RT-PCR) for patients treated with radiotherapy (RT) in our cancer center located in a COVID-19 French hotspot during the first wave of the pandemic.
Methods: Chest CT images were proposed during the radiotherapy CT simulation. Images were reviewed by an expert radiologist according to the CO-RADS classification. Nasal swabs with RT PCR assay were initially proposed in case of suspicious imaging or clinical context and were eventually integrated into the systematic screening. A dedicated radiotherapy workflow was proposed for COVID-19 patients to limit the risk of contamination.
Results: From March 18, 2020 to May 1, 2020, 480 patients were screened by chest CT, with 313 patients having both chest CT and RT-PCR (65%). Cumulative incidence of COVID-19 was 5.4%, 95%CI [3.6, 7.8] (26 patients out of 480). Diagnosis of COVID-19 was made before RT for 22 patients (84.6%) and during RT for 4 patients (15.3%). Chest CT directly aided the diagnosis of 7 cases for whom the initial RT-PCR was negative or not feasible; out of a total of 480 patients (1.5%) and 517 chest CT acquisition. Four patients with COVID-19 at the time of the chest CT screening had a false negative CT. Sensitivity and specificity of chest CT screening in patients with both RT-PCR and chest CT testing were estimated to be 0.82, 95% CI [0.60, 0.95] and 0.98, 95% CI [0.96, 0.99] respectively.Adaptation of the radiotherapy treatment was made for all the patients with seven postponed treatments (median=5 days, IQR [1.5, 14.8]).
Conclusion: The benefit of systematic use of chest CT screening during CT simulation for patients undergoing radiotherapy during the COVID-19 pandemic seemed limited.
Keywords: COVID-19; SARS-CoV-2; cancer; radiotherapy; screening.