Impact Of Covid-19 Crisis On Multidisciplinary Tumour Board Treatment Decisions: A Cohort Analysis From India

Background: COVID-19 crisis has posed newer challenges in cancer care with reports of disruption in treatment plans coming from across the world Massive deluge of COVID-19 incidence in western countries along with the increased risk of fatal complications for active cancer patients made it difficult for cancer patients to maintain continuity of care In India, a countrywide stringent lockdown has prevented a massive exposure to the population Here we present a retrospective analysis of the impact of COVID-19 crisis on the deliberations of online multidisciplinary tumour boards in past 8 weeks Methods: We analyzed 342 tumour board cases where an opinion was provided between 2nd week of March \u0026 3rd week of May 2020 Disease characteristics like primary tumour type, stage, and ECOG PS were recorded A keyword search for COVID-19, Coronavirus, lockdown, treatment delay was performed on the reports to understand if these were mentioned by oncologists during the deliberations We tried to look for any recommendations for deviation from standard treatment or postponement of treatment on account of the COVID situation in the reports Results: Of the 342 cases, 48 patients were diagnosed with haematological malignancies \u0026 rest were solid tumors 213 cases were being treated with curative intent, 92 patients were being treated with palliative intent \u0026 37 cases had just completed staging evaluation and no treatment was started We noted that the tumour board recommended a deviation from standard treatment protocol only for 18 cases on account of COVID-19 The rest of 324 cases received a recommendation to continue the standard treatment protocol for their disease condition The reasons recorded for protocol deviation included patients with oral cavity cancer, metastatic cancer with poor performance status, and patients with multiple comorbidities where they feared a higher risk of complications Conclusions: Majority of oncologists in India prefer standard treatment recommendations in their decisions This could be due to two main factors, a lower infection rate and a much lower case fatality rate (3 4%) from COVID-19 infection as compared to western countries Still treatments have been delayed not due to change in protocols but due to the lockdown Legal entity responsible for the study: The authors Funding: Has not received any funding Disclosure: A K Jotwani, R Jain: Leadership role, Shareholder/Stockholder/Stock options: R S Goud: Shareholder/Stockholder/Stock options, Full/Part-time employment: R Vaghmare;R Rajan: Full/Part-time employment: T Poovaiah: Shareholder/Stockholder/Stock options, Full/Part-time employment: