%0 Journal Article
%T How the COVID-19 Pandemic Impacted on Integrated Care Pathways for Lung Cancer: The Parallel Experience of a COVID-Spared and a COVID-Dedicated Center.
%A Pasello G
%A Menis J
%A Pilotto S
%A Frega S
%A Belluomini L
%A Pezzuto F
%A Caliò A
%A Sepulcri M
%A Cernusco NLV
%A Schiavon M
%A Infante MV
%A Damin M
%A Micheletto C
%A Del Bianco P
%A Giovannetti R
%A Bonanno L
%A Fantoni U
%A Guarneri V
%A Calabrese F
%A Rea F
%A Milella M
%A Conte P
%J Front Oncol
%V 11
%N 0
%D 2021
%M 34262861
%F 5.738
%R 10.3389/fonc.2021.669786
%X <B>BACKGROUND: </B>The COVID-19 pandemic has proved to be a historic challenge for healthcare systems, particularly with regard to cancer patients. So far, very limited data have been presented on the impact on integrated care pathways (ICPs).<BR><B>METHODS: </B>We reviewed the ICPs of lung cancer patients who accessed the Veneto Institute of Oncology (IOV)/University Hospital of Padua (Center 1) and the University Hospital of Verona (Center 2) before and after the COVID-19 pandemic, through sixteen indicators chosen by the members of a multidisciplinary team (MDT).<BR><B>RESULTS: </B>Two window periods (March and April 2019 and 2020) were chosen for comparison. Endoscopic diagnostic procedures and major resections for early stage NSCLC patients increased at Center 1, where a priority pathway with dedicated personnel was established for cancer patients. A slight decrease was observed at Center 2 which became part of the COVID unit. Personnel shortage and different processing methods of tumor samples determined a slightly longer time for diagnostic pathway completion at both Centers. Personnel protection strategies led to a MDT reshape on a web basis and to a significant selection of cases to be discussed in both Centers. The optimization of patient access to healthcare units reduced first outpatient oncological visits, patient enrollment in clinical trials, and end-of-life cancer systemic treatments; finally, a higher proportion of hypofractionation was delivered as a radiotherapy approach for early stage and locally advanced NSCLC.<BR><B>CONCLUSIONS: </B>Based on the experience of the two Centers, we identified the key steps in ICP that were impacted by the COVID-19 pandemic so as to proactively put in place a robust service provision of thoracic oncology.