key: cord-0920709-0i92xqel
authors: Rathod, Shrinivas; Dubey, Arbind; Chowdhury, Amitava; Bashir, Bashir; Koul, Rashmi
title: A call for new 4R’s based Radiation Oncology model in COVID-19 Pandemic
date: 2020-04-25
journal: Adv Radiat Oncol
DOI: 10.1016/j.adro.2020.04.013
sha: 2341493d5775ddc5686bd1d110f1cdb074cef1f3
doc_id: 920709
cord_uid: 0i92xqel

nan

We are in the midst of an unprecedented crisis worldwide. Since its first reports in China on 31 st December 2019, it spread extensively across the globe. As of 4 th April 2020, over 1100,000 cases and over 60000 deaths are reported worldwide. 1 These numbers continue to rise exponentially and the healthcare system is strained to maximum. [15] [16] In these unusual times, the use of reduced fractions/hypofractionation regimens is strongly recommended. Pre COVID19 era, for various reasons, the use of hypofractionated, was highly variable across the world despite supportive data. There is enough data to practice this regimen safely for common cancer sites as prostate, breast, rectum, lung and even palliative situations. 7, 17, 18, 19, 20, 21, 22 The use of hypofractionated and ultra hypofractionated radiation could save potential 10-20 visits, thus lower the risk of infection and even mitigate the risk of treatment breaks and allow the radiation facilities with reduced manpower. With the expected resource and manpower constraints, this model is gaining popularity. 23 A clinical scenario where boost radiation adds minimal benefits to the outcomes is also another potential opportunity to reduce the number of fractions. [24] [25] Judicious resource allocation is paramount and hypofractionation regimens serve a vital purpose. We used this model and proposed thoracic cancer specific provincial consensus. 7 Prostate and breast cancer specific radiation guidelines were recently proposed. 16 

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