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2020 ; 32
(8
): 481-489
Nephropedia Template TP
gab.com Text
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Reduced Fractionation in Lung Cancer Patients Treated with Curative-intent
Radiotherapy during the COVID-19 Pandemic
#MMPMID32405158
Faivre-Finn C
; Fenwick JD
; Franks KN
; Harrow S
; Hatton MQF
; Hiley C
; McAleese JJ
; McDonald F
; O'Hare J
; Peedell C
; Pope T
; Powell C
; Rulach R
; Toy E
Clin Oncol (R Coll Radiol)
2020[Aug]; 32
(8
): 481-489
PMID32405158
show ga
Patients treated with curative-intent lung radiotherapy are in the group at
highest risk of severe complications and death from COVID-19. There is therefore
an urgent need to reduce the risks associated with multiple hospital visits and
their anti-cancer treatment. One recommendation is to consider alternative
dose-fractionation schedules or radiotherapy techniques. This would also increase
radiotherapy service capacity for operable patients with stage I-III lung cancer,
who might be unable to have surgery during the pandemic. Here we identify
reduced-fractionation for curative-intent radiotherapy regimes in lung cancer,
from a literature search carried out between 20/03/2020 and 30/03/2020 as well as
published and unpublished audits of hypofractionated regimes from UK centres.
Evidence, practical considerations and limitations are discussed for early-stage
NSCLC, stage III NSCLC, early-stage and locally advanced SCLC. We recommend
discussion of this guidance document with other specialist lung MDT members to
disseminate the potential changes to radiotherapy practices that could be made to
reduce pressure on other departments such as thoracic surgery. It is also a
crucial part of the consent process to ensure that the risks and benefits of
undergoing cancer treatment during the COVID-19 pandemic and the uncertainties
surrounding toxicity from reduced fractionation have been adequately discussed
with patients. Furthermore, centres should document all deviations from standard
protocols, and we urge all colleagues, where possible, to join
national/international data collection initiatives (such as COVID-RT Lung) aimed
at recording the impact of the COVID-19 pandemic on lung cancer treatment and
outcomes.