20 April 2020

New guidance sets out how doctors can reduce hospital visits for patients needing radiotherapy for blood cancers during the COVID‑19 pandemic.

The guidance has been issued by the International Lymphoma Radiation Oncology Group (ILROG), in response to fears that radiotherapy facilities will be “challenged” by limited space, equipment and staff during the pandemic.

The guidance, published in the journal Blood, makes suggestions for hypofractionated schedules which use fewer, more intense doses to reduce daily visits and so reduce risk of exposure to the virus. It says clinicians may want to consider more use of localised radiotherapy to reduce immunosuppression. The guidance also sets out how radiotherapy might be delayed or omitted for patients with indolent lymphoma.

The lead author, Dr Joachim Yahalom of the Memorial Sloan Kettering Cancer Center, New York, said: “The emergency guidelines provide COVID-19 pandemic-relevant considerations for modifying radiotherapy indications and treatment schedules for patients with haematological malignancies.

“This is an effort to reduce patient and staff exposure by minimising daily visits and still maintain equivalent efficacy and safety profile. The alternative schedules may be individually adjusted within the suggested boundaries.”

Dr Laurie Sehn, of the British Columbia Cancer Centre for Lymphoid Cancer, Canada, said: “This important paper by ILROG provides an excellent example of how the medical community is coming together to create cohesive strategies to adapt treatment in the setting of COVID-19 in order to maintain quality care, while lowering toxicity, minimising viral exposure risk, and decreasing resource utilisation.”

Source: Yahalom J, Dabaja BS, Ricardi U, Ng A, Mikhaeel NG, Vogelius IR, Illidge TM, Qi S, Wirth A, Specht L (2020) “ILROG Emergency Guidelines for Radiation Therapy of Hematological Malignancies During the COVID-19 Pandemic”, Blood, doi: 10.1182/blood.2020006028


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