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A ransomware attack disrupted radiotherapy services, but contingency plans enabled treatment resumption within days. Despite challenges, manual data retrieval and backup hospital collaboration proved effective for patient care continuity.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Health Informatics

Background:

  • Cyberattacks, particularly ransomware, pose a significant threat to healthcare institutions.
  • Radiotherapy departments are highly dependent on digital systems, making them vulnerable to cyber disruptions.
  • Such attacks can severely impact patient care and treatment continuity.

Purpose of the Study:

  • To examine the impact of a ransomware attack on a radiotherapy department.
  • To evaluate the effectiveness of implemented contingency measures for resuming radiotherapy treatments.
  • To assess the dosimetric and clinical outcomes of contingency plans post-cyberattack.

Main Methods:

  • Executed a contingency plan involving manual patient data retrieval and backup hospital collaboration.
  • Prepared and delivered contingency plans rapidly, despite partial information loss.
  • Performed dosimetric analysis comparing original and contingency plans for various cancers (glioblastoma, head and neck, lung).
  • Assessed clinical impact at 1-year follow-up.

Main Results:

  • Radiotherapy treatments resumed within 12 days.
  • Contingency plans allowed some patients to restart treatment 3 days post-attack.
  • Glioblastoma patients showed good outcomes due to generous margins.
  • Head and neck cancer treatment faced target misses due to limited imaging.
  • Lung cancer cases had challenges with central lesions without PET information.
  • Contingency plans often resulted in a higher biological effective dose than delayed treatment.

Conclusions:

  • Robust contingency planning is critical for radiotherapy departments facing digital disruptions.
  • Backup systems and tailored approaches based on tumor type and data availability are essential.
  • Preparedness for cyberattacks requires a focus beyond just IT infrastructure, including operational resilience.