Researchers from the University of Leeds, Public Health England, and the Royal College of Radiologists have investigated the impact that the COVID-19 pandemic has had on the delivery of radiotherapy treatments for cancer during the first wave of the virus in England. Their findings are published in The Lancet Oncology.
Using data from Public Health England's National Radiotherapy Dataset, the team analyzed the number of radiotherapy treatments administered to cancer patients from February to June. They considered factors such as the number of radiotherapy courses and their length, comparing the data with those from the same time period in 2019.
They found that in general, patients received shorter radiotherapy treatments, and some treatments were delayed where it was safe to do so. At the same time, there was also an uptick in radiotherapy numbers, which the team writes, “suggests that radiotherapy compensated for reduced surgical activity.” Furthermore, they also note that while “radiotherapy activity fell significantly, the use of hypofractionated regimens rapidly increased…”
More specifically, the findings from the investigators’ analysis report a fall in radiotherapy treatment courses of 19.9% in April, 6.2% in May, and 11.6% in June 2020, compared with the same months the previous year. Certain cancers, such as breast cancer, saw a very large increase in the use of shorter radiotherapy courses (which have been shown to be just as effective as longer courses). Other cancers, such as bladder, esophageal, and bowel cancers, showed a rise in the use of curative radiotherapy to compensate for delayed surgeries (143.3%, 71.3%, and 36.3%, respectively).
The study results suggest that the NHS was able to adapt quickly to the pandemic in such a way that the overall impact on cancer outcomes will probably be low. Lead author Dr. Katie Spencer, University Academic Clinical Fellow at the University of Leeds and Consultant Clinical Oncologist at Leeds Teaching Hospitals NHS Trust, commented:
"Radiotherapy is a very important treatment option for cancer, and our study shows that across the English NHS there was a rapid shift in how radiotherapy was used. It is impressive to see that the data closely follows the guidelines published at the start of the pandemic. For cancers such as breast and bowel, shorter, more intensive treatments were delivered to provide similar outcomes for patients. Where treatment delay is safe, like in prostate cancer, delays were used to reduce the risk of coronavirus exposure. This was particularly important for older patients, who are more vulnerable to the virus. In other cases, such as head and neck, and anal cancers, we saw that the number of radiotherapy treatments hardly changed during the first wave. This was really reassuring, as we know that it is vital that these treatments are not delayed."