Outcomes of cancer patients undergoing radiotherapy during the COVID 19 outbreak in Wuhan, China

Background: COVID-19 has affected more than 4,000,000 patients worldwide Patients with cancer are at a higher risk of COVID-19, but currently, there is no evidence-based guidance on the management of cancer patients during this outbreak We report the early outcomes of cancer patients, who received radiotherapy (RT) at the time of implementation of non-pharmacological interventions (NPI) in Wuhan Methods: 209 patients from a single institution cancer center in Wuhan from Jan 20 to Mar 6, 2020 were reviewed NPI measures that were implemented during the study period included city lockdown (Jan 23, 2020), cordons sanitaire, traffic restriction, social distancing and home confinement Infection control measures at the hospital included on-site screening, physical distancing, disinfection procedures, and protection of healthcare workers (HCWs) Primary end-point was rate of COVID-19 infection Study was approved by the institutional review board Results: Median age was 55 y (IQR = 48-64);104 (49 8%) and 105 (50 2%) of patients were males and females, respectively Thoracic (N = 80, 38 3%), head and neck (N = 53, 25 4%), and lower gastrointestinal and gynaecological cancer (N = 54, 25 3%) patients consisted the majority of patients Treatment sites included thoracic (38 3%), head and neck (25 4%), and abdomen and pelvis (25 8%) 47 4%, 27 3%, and 25 4% of treatments were for adjuvant, radical, and palliative indications, respectively;67 (32 1%) and 142 (67 9%) patients received concurrent chemoRT and RT alone, respectively RT interruptions occurred in 112 (53 6%) patients, while 62 of 67 (92 5%) patients who received chemoRT discontinued chemotherapy 188 treatments/day were performed pre-lockdown, in contrast to 12 4 treatments/day post-lockdown One (0 48%) patient was diagnosed with COVID-19 during the study period 70 patients were linked to this index patient following contact tracing, but none developed COVID-19 No HCW was infected Conclusions: Herein, we showcased the low rates of COVID-19 among patients and HCWs with tight infection control measures However, city lockdown substantially affected the delivery of RT in cancer patients Long-term data will reveal the detrimental effect of treatment interruption on their survival Legal entity responsible for the study: The authors Funding: National Medical Research Council;Health Commission of Hubei Province Disclosure: All authors have declared no conflicts of interest