key: cord-326994-y8p724s4
authors: Mohamad, Osama; Roach, Mack
title: Delaying Dilemmas: Coronavirus Complications Impacting the Management of Prostate Cancer
date: 2020-10-01
journal: Int J Radiat Oncol Biol Phys
DOI: 10.1016/j.ijrobp.2020.07.009
sha: 
doc_id: 326994
cord_uid: y8p724s4

nan

With the increases in the numbers of SARS-CoV-2 cases, and after lengthy discussions regarding reasonable and safe delays for UIR patients, 2 the patient elected to delay SBRT due to his concerns about viral exposure. He received a 1-month leuprolide depot injection in March 2020 as a bridge to SBRT but missed a 3-month shot in April because of fear of exposure. He was planned for a computed tomography simulation in May as clinics started reopening but was lost to follow-up for several additional months because of his fears of exposure.

During a COVID-19 second wave surge several months later, the patient has a repeat prostate biopsy that shows Gleason score 4 þ 4 in all 6 out of 12 cores. He continues to refuse surgery and requests RT with androgen deprivation therapy.

1. Taking into consideration your hospital policies and regional COVID-19 considerations, would you have done anything differently in March 2020?

a. What is your recommended fractionation for UIR patients?

2. How would you approach management of this patient after he re-presents with high-risk disease?

a. Are you irradiating elective lymph nodes for high-risk cases during this time? What if the patient has baseline lymphopenia?

b. Would you test this patient for SARS-CoV-2 infection? When and how often?

3. Has anything permanently changed about your management of UIR or high-risk cases as a result of the pandemic?

Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer: 5-year outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial

Prostate cancer radiotherapy recommendations in response to COVID-19

See expert opinions on page 338. What would you do? Follow the discussion on Twitter at #gyzone, and take the poll at www.redjournal.org/poll. NotedCME is available for this feature as an ASTRO member benefit