key: cord-0989199-o2zuw2d4
authors: Higgins, E.; Walters, S.; Powell, E.; Staffurth, J.
title: We are now planning for our recovery phase, while continuing to provide the safest care possible for our patients
date: 2020-05-27
journal: Clin Oncol (R Coll Radiol)
DOI: 10.1016/j.clon.2020.05.013
sha: 1de83283a1eb440e01e9157fdca275db28797020
doc_id: 989199
cord_uid: o2zuw2d4

nan

Authors are required to identify the contributions for which they are responsible. The author responsible for the integrity of the entire study should be identified. Please list the following phrases and beside each indicate the name(s) of the author(s) to whom they apply: Items that do not apply should also be indicated with N/A. Where there is any uncertainty regarding authorship the editor of the study reserves the right to contact the guarantor of the study for further information.

Authors: On 23 March 2020, the Government announced a period of lockdown. We compared the subsequent 3 weeks with the same period in 2019.

Overall attendances to the radiotherapy department dropped by 28%. In the 2020 period, 74% of all attendances involved five tumour sites: breast (23%), urological (20%), head and neck (14%), colorectal (9%) and lung (8%). These figures were similar for 2019 except for urological sites due to (i) deferral of prostate radiotherapy and (ii) interim hormone treatment.

The biggest changes have occurred in the use of fractionation regimens. For breast cancer, there was an increase in the use of five-fraction regimens, with 48% of patients receiving 26 Gy in five fractions in 2020, up from 13% in 2019. This was supported by international consensus guidelines, together with the Fast-forward trial [2, 3] .

For head and neck patients, there was an increase in the 20-fraction regimen. These accounted for 18% patients in 2020, compared with 10% in 2019. Thirty-fraction regimens increased to 82% from 70%; 0% attended for a 35-fraction regimen (compared with 10% in 2019). The consensus advice is to consider hypofractionated regimens [4].

Short-course radiotherapy for rectal cancer has accounted for 75% of attendances in 2020 compared with 0% for 2019. International consensus guidelines advocate using shortcourse radiotherapy (25 Gy in five fractions) for patients traditionally treated with [AQ1]LCCRT [5] .

The coronavirus epidemic has undoubtedly led to significant changes in the treatment of patients resulting from (i) changing referral patterns, (ii) treatment criteria and (iii) moving towards shorter fractionation schedules.

We are now planning for our recovery phase, while continuing to provide the safest care possible for our patients. 

International guidelines on radiation therapy for breast cancer during the COVID-19 pandemic

Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial

International expert consensus statement regarding radiotherapy treatment options for rectal cancer during the COVID 19 pandemic

AQ1 SCRT has been changed to 'short-course radiotherapy'. Please spell out LCCRT (longcourse chemoradiotherapy?)

☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.☐The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: