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. 2022 Aug 29;29(9):6226-6235.
doi: 10.3390/curroncol29090489.

The Impact of Virtual Cancer Care on Chemotherapy Delivery and Clinical Outcomes in Colorectal Cancer Patients Receiving Systemic Therapy: A Pre- and Intra-Pandemic Analysis

William J Phillips  1 , Macyn Leung  2 , Kednapa Thavorn  2   3 , Timothy R Asmis  2   4
Affiliations

The Impact of Virtual Cancer Care on Chemotherapy Delivery and Clinical Outcomes in Colorectal Cancer Patients Receiving Systemic Therapy: A Pre- and Intra-Pandemic Analysis

William J Phillips et al. Curr Oncol. .

Abstract

(1) Background: The coronavirus 2019 pandemic has resulted in an abrupt transition to virtual oncology care worldwide. This study's objective is to evaluate chemotherapy delivery and clinical outcomes in patients on systemic treatment for colorectal cancer before and during the pandemic. (2) Methods: Clinical data was collected on patients with colorectal cancer receiving intravenous chemotherapy at The Ottawa Hospital from June 2019 to March 2021. Patients were stratified by whether they were started on chemotherapy pre-pandemic (June 2019-January 2020) or intra-pandemic (February 2020-March 2021). Multiple regression analysis was used to compare outcomes between pandemic periods; (3) Results: There were 220 patients included in this study. The proportion of virtual consultations (1.2% to 64.4%) and follow-up visits (5.2% to 83.3%) increased during the pandemic. There was no difference in the incidence of treatment delays (OR = 1.01, p = 0.78), chemotherapy dose reductions (OR = 0.99, p = 0.69), emergency department visits (OR = 1.23, p = 0.37) or hospitalizations (OR = 0.73, p = 0.43) between pandemic periods. A subgroup analysis revealed no difference in outcomes independent of the presence of metastases; (4) Conclusion: These findings serve as an important quality-care indicator and demonstrate that virtual oncology care appears safe in a cohort of high-risk colorectal cancer patients.

Keywords: COVID-19; chemotherapy; colorectal cancer; virtual care.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The relationship of visit type over time during the observation period. The Y-axis represents the proportion of virtual visits.
Figure 2
Figure 2
Subgroup analysis of patients with (a) nonmetastatic and (b) metastatic colorectal cancer represented as a Forest Plot of the point estimates and 95% confidence intervals for each outcome compared in the pre- versus intra-pandemic period, where a positive estimate indicates that the outcome is more likely in the intra-pandemic period. Models adjusted for age, chemotherapy type, modified Charlson comorbidity index, and number of cycles received.
See this image and copyright information in PMC

References

    1. Canadian Cancer Statistics Advisory Committee . Canadian Cancer Statistics. Canadian Cancer Statistics Advisory Committee; Toronto, ON, Canada: 2021. pp. 1–95.
    1. Loupakis F., Cremolini C., Masi G., Lonardi S., Zagonel V., Salvatore L., Cortesi E., Tomasello G., Ronzoni M., Spadi R., et al. Initial Therapy with FOLFOXIRI and Bevacizumab for Metastatic Colorectal Cancer. N. Engl. J. Med. 2014;371:1609–1618. doi: 10.1056/NEJMoa1403108. - DOI - PubMed
    1. Saltz L.B., Clarke S., Díaz-Rubio E., Scheithauer W., Figer A., Wong R., Koski S., Lichnitser M., Yang T.S., Rivera F., et al. Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: A randomized phase III study. J. Clin. Oncol. 2008;26:2013–2019. doi: 10.1200/JCO.2007.14.9930. - DOI - PubMed
    1. Aparicio T. Oxaliplatin, fluorouracil and leucovorin as adjuvant treatment for colon cancer. Colon Rectum. 2011;5:33–55. doi: 10.1007/s11725-011-0275-8. - DOI
    1. Kelly H., Goldberg R.M. Systemic therapy for metastatic colorectal cancer: Current options, current evidence. J. Clin. Oncol. 2005;23:4553–4560. doi: 10.1200/JCO.2005.17.749. - DOI - PubMed