COVID-19 Continued: Successes, Setbacks and Effects on Radiation Oncology

As 2021 draws to a close, we have much to be thankful for: a new generation of COVID-19 treatments on the horizon, very low death rates for fully vaccinated adults under 50, booster shot eligibility, and numerous other strides in our continued battle against the coronavirus.

Although we have made progress over the past two years, the pandemic and its repercussions are far from over. Unvaccinated people remain at considerable risk of serious effects. The Omicron variant is ushering in a new wave of uncertainty. And the mental, physical, and financial tolls are staggering, particularly among cancer patients.

Key to alleviating this ongoing distress on patients, providers, and practices is a better understanding of the economic ramifications of COVID-19 on radiation treatment delivery, as described in an outstanding review article titled The Economic Impact of the COVID-19 Pandemic on Radiation Oncology Practice. The authors examine COVID’s fallout on core radiation oncology activities such as departmental management

and evidence generation, and the impact on surgery and systemic treatments. Building this knowledge will help steer evidence-based resource allocation and identify creative opportunities to support value-based care in times of ambiguity.

We are also pleased to feature the thought-provoking research article, Formalized Mentorship in Radiation Oncology in the COVID Era: American College of Radiation Oncology Experience. This article summarizes the results and effectiveness of the ACRO Mentorship Program 2020-2021 at a time when unique challenges such as physical distancing, financial losses, and competing priorities remain widespread.

An additional article addressing COVID in radiation oncology is Radiation Recall After the COVID-19 Vaccine: Two Cases and a Review of the Literature. This timely report examines radiation recall postmastectomy dermatitis and radiation recall proctitis in two patients after their COVID-19 vaccination, and describes potential effects of the vaccine to consider when counseling patients.

In addition to our COVID lineup, we are pleased to offer the SA-CME-accredited article, Stereotactic Body Radiation Therapy (SBRT) vs Stereotactic Ablative Radiation Therapy (SABR): Does Terminology Differentiate Treatment Intent in Metastatic Cancer? In this review of prospective trials and protocols on stereotactic radiation therapies for metastatic disease, the authors determine whether the terms SBRT and SABR are being used differentially according to treatment intent and propose a distinct definition of each.

Also featured are two other noteworthy and comprehensive case reports, one detailing the use of MR-guided radiation therapy for oligometastatic central lung cancer, and the other describing the rare phenomenon of delayed radiation-related transient, symptomatic cerebral demyelination following treatment of a secretory pituitary macroadenoma.

Finally, the Technology Trends department highlights new and updated technologies featured at ASTRO 2021, and the Resident Voice editorial stresses the critical need for advocacy during residency (and beyond), especially in light of the recent unprecedented changes in radiation therapy supervision requirements, major proposed cuts in Medicare reimbursement, and the Radiation Oncology Alternative Payment Model, which has been delayed until 2023. We look forward to bringing you more on this topic in our March issue.

Until then, please enjoy our December edition and have a safe and joyful holiday season! We are immensely grateful for your support over these last 10 years, especially given the complexities and challenges of COVID-19. We wish you a 2022 full of peace, promise, happiness, and growth!