Community-Led Action Research in Oncology: Pandemic-Appropriate Radiotherapy Innovations Evaluated (CLARO PARTE) for Latin America and the Caribbean Countries

Author:

Riano Ivy1ORCID,Alas-Pineda César2ORCID,Reyes Garcia Sarahi2ORCID,Murillo Raúl3ORCID,Gutiérrez-Delgado Francisco4ORCID,Cazap Eduardo5ORCID,Pais Viegas Celia Maria6,Torre Marcela de la7,Barahona Kaory C.8,Sarria Gustavo J.9ORCID,del Castillo Bahi Ramón10,Luongo-Céspedes Álvaro11,Ovalles Beatriz12,Umaña Herrera Flory Vanessa13ORCID,Sánchez Ricardo3,McVorran Shauna14ORCID,Williams Benjamin14ORCID,Kascmar Joseph15,Kennedy Linda S.16ORCID,Lyons Kathleen D.17,Bejarano Suyapa2ORCID,Wong Sandra L.1819ORCID

Affiliation:

1. Division of Hematology and Oncology, Dartmouth Cancer Center, Dartmouth Health, Geisel School of Medicine at Dartmouth, Lebanon, NH

2. Division of Radiation Oncology, Liga Contra El Cáncer, San Pedro Sula, Honduras

3. Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia

4. Centro de Estudios y Prevención del Cáncer, Latin American School of Oncology, Tuxtla Gutiérrez, México

5. Latin-American and Caribbean Society of Medical Oncology (SLACOM), Buenos Aires, Argentina

6. Department of Radiation Oncology, Instituto Nacional de Cáncer, Brazil National Cancer Institute, Rio de Janeiro, Brazil

7. Division of Oncology, Hospital de Clínicas, Universidad de Buenos Aires, Buenos Aires, Argentina

8. Division of Radiation Oncology, International Cancer Center, Diagnostic Hospital, San Salvador, El Salvador

9. Dirección General de Control de Cancer, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru

10. Department of Radiation Oncology, Instituto Nacional de Oncología y Radiobiología, La Habana, Cuba

11. Instituto Nacional de Cáncer, Montevideo, Uruguay

12. Department of Radiation Oncology, Centro de Cancer Homs, Santiago de los Caballeros, Dominican Republic

13. Department of Radiation Oncology, Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica

14. Department of Radiation Oncology and Applied Science, Dartmouth Cancer Center, Lebanon, NH

15. Department of Surgery, Dartmouth Health, Geisel School of Medicine at Dartmouth, Lebanon, NH

16. Strategic Initiatives & Global Oncology at the Dartmouth Cancer Center, Dartmouth Health, Lebanon, NH

17. Department of Occupational Therapy, Massachusetts General Hospital (MGH) Institute of Health Professions, Boston, MA

18. Department of Surgery, Dartmouth Cancer Center, Dartmouth Health, Geisel School of Medicine at Dartmouth, Lebanon, NH

19. The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH

Abstract

PURPOSE This study aimed to identify, evaluate, and rank suitable safety innovations developed during the COVID-19 pandemic in Latin American and Caribbean (LAC) radiation oncology centers. METHODS We conducted a multimodal participatory engagement collaboration with the Latin-American and Caribbean Society of Medical Oncology. The study consisted of four phases. Innovations were collected from a panel of radiotherapy experts representing a diverse group of 11 countries from LAC (Phase I). Next, a medical scientific team compared the innovations against international standards regarding their potential impact on risk of infection, clinical operation, and continuity of quality cancer care (Phase II). Their findings were supplied to the country representatives who rated the innovations for acceptability in their cancer centers (Phase III), resulting in a final report of the panel's recommendations (Phase IV). RESULTS A total of 81 innovations were reported by the country representatives and merged by the medical scientific team into 24 innovations that combined similar innovations. The 24 innovations were grouped into six categories including practices aimed at (1) reducing clinic crowding (n = 3), (2) increasing screening and vaccinations for COVID-19 disease (n = 5), (3) implementing social distancing (n = 6), (4) strengthening personal infection equipment and disinfection (n = 6), (5) avoiding delaying or shortening treatment protocols (n = 2), and (6) mixed procedures (n = 2). The medical scientific team found nearly all innovations were supported by international recommendations and rated as safe, efficient, and acceptable. CONCLUSION By using the lessons learned from the Community-Led Action Research in Oncology: Pandemic-Appropriate Radiotherapy Innovations Evaluated study, a manual of scalable practices in radiation oncology clinics may be developed to guide actions during future large-scale public health crises in low- and middle-income countries of LAC.

Publisher

American Society of Clinical Oncology (ASCO)

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