Reduced Fractionation in Lung Cancer Patients Treated with Curative-intent Radiotherapy during the COVID-19 Pandemic

Area of Science:

• Oncology
• Radiotherapy
• Public Health

Background:

• Patients undergoing curative-intent lung radiotherapy face high COVID-19 risks.
• The pandemic necessitates reducing hospital visits for cancer treatment.
• Alternative radiotherapy approaches can preserve capacity for operable lung cancer patients.

Purpose of the Study:

• To identify reduced-fractionation radiotherapy schedules for lung cancer.
• To discuss evidence, practicalities, and limitations of hypofractionation.
• To guide radiotherapy practices during the COVID-19 pandemic.

Main Methods:

• Literature search for reduced-fractionation regimes (March 20-30, 2020).
• Review of published and unpublished UK center audits of hypofractionated lung cancer treatments.
• Discussion of evidence for early-stage NSCLC, stage III NSCLC, and SCLC.

Main Results:

• Reduced-fractionation schedules are identified as a viable alternative.
• Evidence, practical considerations, and limitations are discussed for various lung cancer types.
• Guidance for adapting radiotherapy practices is proposed.

Conclusions:

• Adapting radiotherapy fractionation is crucial for patient safety and treatment continuity during COVID-19.
• Multidisciplinary team discussion and patient consent are vital for modified treatment protocols.
• Data collection on pandemic impact on lung cancer treatment is essential.