Atendimento a pacientes oncológicos em um serviço de radioterapia no contexto da pandemia de covid-19

Abstract

Introduction: The COVID-19 pandemic, which began in 2019 and is still present nowadays, ended up overloading care in health systems. Due to the disease itself and its treatments, cancer patients are more susceptible to infections in general. Still, delays in making diagnoses and treatments, a decrease in the number of patients in oncology services and worsening of tumor staging are already a reality in these institutions. Objective: To describe the characteristics of cancer patient care in a radiotherapy service of a philanthropic hospital in the context of the COVID-19 pandemic. Materials and Methods: This was an ambispective analytical study, which included all the medical records of the patients that were included in the monthly report of scheduling for the beginning of radiotherapy treatment in a High Complexity Oncology Unit, in a philanthropic hospital in Salvador (BA), during the period from January 2019 to December 2021. Information about gender, age, place of residence, date of the initial consultation for radiotherapy, date of the first radiotherapy session, malignant tumor stage (TNM) and the patient's tumor type were collected. Associations were made between sex, age and place of residence with the time between the first diagnosis of radiotherapy and the first session in the three years studied, in addition to the association of the TNM values observed in each year of the study. Results: A total of 1,488 medical records were evaluated, 488/882 in 2019, 503/758 in 2020 and 497/749 in 2021. Most patients were female (68.6%) and residents of the city of Salvador in the three years studied. The predominant age group was over 60 years old. The main neoplasms described were breast, head and neck, prostate and cervix cancer. According to the obtained results, there was a worsening in the tumor staging of the studied population, with a significant association for lymph nodes (N) and metastasis (M) (p<0.05) between the years 2019 and 2021. It was possible to observe a decrease in the percentage of cases classified as 0 and an increase in cases classified as 1 for both N and M assessments. An analysis of the time between the first diagnosis of radiotherapy and the start of therapy showed a reduction of 75.1 days in 2019 to 23.5 days in 2021. Conclusions: There were no significant changes in the number of patients seen and in their profile over the years of the pandemic. Among the obtained results, the worsening of the clinical tumor staging with regard to N and M values can be highlighted, as well as a reduction in the time between the 1st diagnosis and the 1st treatment session over the years.