COVID-19: Postponement or interruption of radiotherapy should be avoided

Radiotherapy should not be postponed or interrupted even during the COVID 19 pandemic. This also includes brachytherapy in the form of HDR afterloading. This is pointed out by the Working Group for Radiological Oncology (ARO) and the German Society for Radiooncology (DEGRO) in a current statement.

Cancer patients are probably more susceptible to a severe course of Covid-19 disease and are therefore afraid of infection during oncological treatment. In addition, according to Federal Health Minister Jens Spahn, unnecessary medical interventions should be postponed if possible. "However, patients who receive oncological treatment cannot do so without further ado," states the German Society for Radiooncology. Aborting a cancer therapy, e.g. radiotherapy, hormone treatment or chemotherapy, or postponing it for weeks or even months could under certain circumstances mean risking a relapse of the tumor disease.

Maintenance of necessary oncological therapies

In principle, DEGRO therefore believes that the supply of cancer patients with necessary, possibly life-saving therapies should be maintained. In some cases, however, consideration could be given to making changes to the treatment regime (course of treatment). For example, in patients with prostate carcinoma, it is possible to prescribe a drug-based hormone therapy and then irradiate the tumour later. The changed therapy sequence does not lead to a loss of survival and could be useful in the current situation, so that patients have to go for treatment less frequently, the statement says. Individual consultation of the patient is indispensable.

No increased risk of infection through radiation treatment

At the same time, DEGRO advises to take increased security precautions. While radiotherapy itself does not mean an increased risk of infection for the patient, it is important that the recommendations of the Robert Koch Institute and the local hygiene commissions are followed, e.g. that patients maintain the necessary distance of 1.5-2 m from other people and that hand hygiene is taken seriously.
In the event of fever, coughing flu-like symptoms or contact with a Covid-19 patient, it is essential to contact the attending physician by telephone so that he or she can discuss further procedures with the patient. The protection of the patient as well as of the staff is of utmost importance. Even if a patient has tested positive for the coronavirus, this does not necessarily mean that the therapy must be stopped immediately. The risk and benefit must then be weighed up on a patient-specific basis, DEGRO emphasizes.

Literature:
Stellungnahme der ARO, DEGRO und des Berufsverbandes zur Strahlentherapie während der COVID- 19 Pandemie
Mitteilung DEGRO, März 2020: Strahlentherapie zu Zeiten von Corona?

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