Examining Cancer Patients' Perceptions of the Impact of COVID-19 on Teleoncology: Findings From 15 Nigerian Outpatient Cancer Clinics.

PURPOSE: To examine cancer patients' perspectives on the impact of COVID-19 on teleoncology in Nigeria. METHODS: Data from a multicenter survey conducted at 15 outpatient clinics to 1,097 patients with cancer from April and July 2020 were analyzed. The study outcome was telemedicine, defined as patients who reported their routine follow-up visits were converted to virtual visits because of COVID-19 (coded yes/no). Covariates included patient age, ethnicity, marital status, income, cancer treatment, service disruption, and cancer diagnosis/type. Stata/SE.v.17 (StataCorp, College Station, TX) was used to perform chi-square and logistic regression analyses. P values ≤ .05 were considered statistically significant. RESULTS: The majority of the 1,097 patients with cancer were female (65.7%) and age 55 years and older (35.0%). Because of COVID-19, 12.6% of patients' routine follow-ups were converted to virtual visits. More patients who canceled/postponed surgery (17.7% v 7.5%; P ≤ .001), radiotherapy (16.9% v 5.3%; P ≤ .001), and chemotherapy (22.8% v 8.5%; P ≤ .001), injection chemotherapy (20.6% v 8.7%; P ≤ .001) and those who reported being seen less by their doctor/nurse (60.3% v 11.4%; P ≤ .001) reported more follow-up conversions to virtual visits. In multivariate analyses, patients seen less by their doctors/nurses were 14.3 times more likely to have their routine follow-ups converted to virtual visits than those who did not (odds ratio, 14.33; 95% CI, 8.36 to 24.58). CONCLUSION: COVID-19 caused many patients with cancer in Nigeria to convert visits to a virtual format. These conversions were more common in patients whose surgery, radiotherapy, chemotherapy, and injection chemotherapy treatments were canceled or postponed. Our findings suggest how COVID-19 affects cancer treatment services and the importance of collecting teleoncological care data in Nigeria.

Patient's Perspective on the Impact of COVID-19 on Cancer Treatment in Nigeria.

PURPOSE: Because of the global COVID-19 pandemic, health care organizations introduced guidelines for modifications to health and cancer medical care delivery to mitigate transmission and ensure quality health outcomes. To examine the extent and impact of these modifications on oncology service disruptions in Nigeria, we surveyed oncology patients across selected public and private cancer treatment centers. MATERIALS AND METHODS: Participating in the study were 15 tertiary cancer treatment centers across 12 Nigerian states. We recruited adult patients with cancer (18+ years) on active treatment to complete a self-administered survey on cancer care during COVID-19. We conducted descriptive and multivariate data analysis using Stata 16.1. RESULTS: Respondents were (n = 1,072), female (65.7%), ages 18-49 years (50.3%), and married (80.7%). The top two cancers were breast and prostate. Overall, 17.3% of respondents reported disruptions to cancer care, and more than half (51.0%) reported difficulties accessing care. Changes in chemotherapy regimens or route of administration were reported in 8.4% of respondents. Odds for any disruption were highest for older patients, western states, patients with prostate cancer, and patients with two or more flu symptoms. Odds for radiotherapy cancellation were highest for older patients, those with prostate cancer, and those with medium service perception. CONCLUSION: This study investigated COVID-19-influenced cancer treatment disruptions in Nigeria. Patients with cancer experienced significant disruptions to cancer care. Vulnerable patients are most likely to be negatively affected. Policies and strategies aimed at minimizing service disruptions while maintaining cancer patients' safety should be a priority for all health care institutions in the COVID-19 era.

Study of the relationships between brachytherapy plan parameters in an attempt to verify total dwell time in vaginal cylinder applications.

PURPOSE: Source strength (Sk ), sizes of vaginal cylinder applicators (VCA), number of dwell positions (DPs), and the prescribed dose (D) are basic parameters in brachytherapy (BT) treatment planning contributing to total dwell time (TDT). This study was aimed at assessing the relationships between the specified variables in an attempt to verify the TDT in high-dose-rate (HDR) vaginal cylinder applications. METHODS: One hundred and twenty-one patients treated with Gynesource-Co60 (Bebig, Germany) using VCAs of diameters 20, 25, and 30 mm at University College Hospital, Nigeria, were enrolled in this study. Brachytherapy doses ranging from 3 to 7 Gy were always prescribed to points 5 mm away from the cylinder's surface. Treatment planning was undertaken on HDR-Basic treatment planning system (TPS) which utilizes source step size of 5 mm. Data on the stated parameters related to the first BT fractions of the patients were acquired. With the aid of EViews statistical software, two forms of mathematical models were thereafter developed. The resulting TDTs from the models were compared with the TPS values using Minitab statistical software. RESULTS: The relationships obtained for the increasing sizes of the VCA were TDT1(min)=2.22+3.17DSk;TDT1(min)=3.52+3.74DSk;TDT1(min)=-1.96+6.91DSkandTDT2(min)=0.50-0.03Sk+0.02D+0.55DPs;TDT2(min)=7.08-0.06Sk+0.02D+0.67DPs;TDT2(min)=7.02-0.11Sk+0.03D+1.25DPs The model-based TDTs correlate with the TPS-calculated values with r1 = 0.80 (P = 0.412) and r2 = 0.97 (P = 0.468). CONCLUSIONS: The findings of this study could suggest likely variations in the treatment time when certain changes occur in the related parameters. The increasing size of the vaginal cylinder has a positive influence on the brachytherapy treatment time. The latter model has been a useful tool in the verification of the dose delivery time at the first HDR brachytherapy center in Nigeria and West Africa.