Delays in chemotherapy and radiotherapy of breast cancer during COVID-19 pandemic

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES Journal of Infection and Public Health Pub Date : 2025-01-08 DOI:10.1016/j.jiph.2025.102657

Moein Rast , Arash Tehrani-Banihashemi , Pedram Fadavi , Marzieh Nojomi , Donya Hatami , Kiarash Ansari , Seyyed Amir Yasin Ahmadi

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Abstract

Background

During the COVID-19 pandemic, hospitals were overwhelmed with infected patients, leading to a disruption in the delivery of services. Patients with cancer, including breast cancer, rely on timely treatment, as delays can reduce survival rates. In this study, we investigated delays in treatment and the factors contributing to delays in chemotherapy and radiotherapy for these patients.

Method

All women with breast cancer who received chemotherapy or radiotherapy at academic hospitals of Iran University of Medical Sciences from February 20, 2020, to March 20, 2022, were included in our study. Age and metastasis status, including the presence of any metastasis, were also recorded. Delays were calculated for each chemotherapy session, as well as the total number of delays for each patient. For patients who received radiotherapy, delays in the whole course of radiotherapy were calculated. Logistic and Poisson regression with Incidence Rate Ratio (IRR) was used to analyze the number of delays and the impact of pandemic waves.

Results

The results of the study showed an association between metastasis and delays in chemotherapy for breast cancer. Having metastatic breast cancer before the start of treatment was also associated with the increasing number of delays in the entire course of chemotherapy (IRR=1.44). Delays among radiotherapy patients weren’t associated with age or metastasis of the disease. The first (IRR=2.74), second (IRR=2.64), third (IRR=1.26), and fourth (IRR=1.44) pandemic waves in chemotherapy and first (IRR=2.56), second (IRR=6.45), fifth (IRR=2.36), and sixth (IRR=2.13) waves in radiotherapy were associated with longer delays compared to plateau times of pandemic.

Conclusion

In this study, having metastatic breast cancer before the start of treatment was associated with higher rates of delays in chemotherapy. Also, COVID-19 pandemic waves, specifically the early waves, were associated with longer delays in both chemotherapy and radiotherapy. However, the impact of these delays on patient survival requires further study.

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COVID-19大流行期间乳腺癌化疗和放疗延迟

背景：在2019冠状病毒病大流行期间，医院因感染患者而不堪重负，导致服务中断。包括乳腺癌在内的癌症患者依赖于及时治疗，因为延误会降低生存率。在本研究中，我们调查了这些患者的治疗延迟以及导致化疗和放疗延迟的因素。方法：选取2020年2月20日至2022年3月20日在伊朗医科大学附属学术医院接受化疗或放疗的女性乳腺癌患者为研究对象。年龄和转移状态，包括任何转移的存在，也被记录。计算每个化疗疗程的延迟，以及每个患者的延迟总数。对于接受放疗的患者，计算整个放疗过程的延迟时间。采用Logistic回归和泊松回归（IRR）分析延误次数和大流行波的影响。结果：研究结果显示乳腺癌转移与延迟化疗之间存在关联。在治疗开始前患有转移性乳腺癌也与整个化疗过程中延迟的数量增加有关（IRR=1.44）。放疗患者的延迟与年龄或疾病转移无关。化疗中的第1波（IRR=2.74）、第2波（IRR=2.64）、第3波（IRR=1.26）和第4波（IRR=1.44）和放疗中的第1波（IRR=2.56）、第2波（IRR=6.45）、第5波（IRR=2.36）和第6波（IRR=2.13）与大流行的平台时间相比，延迟时间更长。结论：在这项研究中，在治疗开始前患有转移性乳腺癌与化疗延迟率较高相关。此外，COVID-19大流行波，特别是早期波，与化疗和放疗延迟时间较长有关。然而，这些延迟对患者生存的影响需要进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.