Optimizing lung cancer radiation treatment worldwide in COVID-19 outbreak

Abstract

COVID-19 has spread around the planet, sending billions of people into lockdown as health services struggle to cope. By April 2020, there are over a million two hundred thousand confirmed cases and more than sixty-five thousand deaths worldwide Meanwhile in Asia, where the disease began, the spread continues, in China it seems for now to have passed its peak. Italy, Spain, France, and the US have been the countries more affected in terms of deaths. The coronavirus is more dangerous to the elderly and those with certain pre-existing medical conditions which is precisely the profile of lung cancer patients. Essential cancer services should be delivered but all steps should be taken to protect patients and the health workforce from infection with COVID-19. This presents a major challenge to radiotherapy (RT) departments worldwide in curbing the spread of COVID-19 while ensuring the continuity of services. In RT, shortening overall treatment time to reduce the number of patients present in the department is an important consideration. An international panel, including the majority of countries most affected by the COVID-19 pandemic, with expertise in the management of cancer in high-volume comprehensive centres from the largest societies of radiation oncology worldwide have come together to share their experience on COVID-19 preparedness in the context of lung cancer RT to deliver optimal care in such exceptional circumstances, based on the latest evidence. A comprehensive systematic review of the literature through a PubMed search was undertaken. Given that lung cancer is one of the most common and severe pathologies in radiation oncology departments, the following recommendations require particularly urgent consideration. The decision-making paths strongly depend on locally available resources, and a tailored approach should be used to attend lung cancer patients during this pandemic.