Radiotherapy treatment interruptions during the Covid-19 pandemic: The UK experience and implications for radiobiology training. (November 2022)

• Record Type: Journal Article
• Authors: Dale, R.G.; Jones, B.
• Is Part Of: Radiation physics and chemistry. Volume 200(2022)
• Publication Date: 2022-11
• Subjects: Covid-19 -- Radiotherapy -- Radiobiology -- Radiotherapy treatment interruptions; Radiation chemistry -- Periodicals; Radiometry -- Periodicals; Radiation -- Periodicals; Chimie sous rayonnement -- Périodiques; 539.2
• DOI: 10.1016/j.radphyschem.2022.110214
• Languages: English
• ISSNs: 0969-806X

Abstract

Abstract: Unintended treatment interruptions during a course of radiotherapy can lead to extended overall treatment times which allow increased tumour cell repopulation to occur. Extra dose may therefore be required to offset any loss of tumour control. However, the manner in which the extra dose is delivered requires careful consideration in order to avoid the risk of increased normal tissue toxicity. Radiobiological modelling techniques can allow quantitative examination of such problems and may be used to derive revised pattens of radiation delivery which can help restore a degree of tumour control whilst limiting the likelihood of excess normal tissue morbidity. Unintended treatment interruptions can occur in any radiotherapy department but the rapid spread of the Covid-19 pandemic caused a major increase in the frequency of such interruptions due to staff and patient illness and the consequent self-isolation requirements. This article summarises the radiobiological considerations and caveats involved in assessing treatment interruptions and outlines the UK experience of dealing with the new challenges posed by Covid-19. The world-wide need for more education programmes in cancer radiobiology is highlighted. Highlights: The reasons why radiotherapy treatment interruptions can reduce tumor control. Radiobiology relevant to treatment interruptions. Discussion of quantitative methods for assessing the consequences of treatment interruptions and for devising compensations. How Covid-19 has increased the demand for radiobiology expertise and the requirement for more formalised training schemes.