Initiation of the Global Coalition for Radiotherapy during the COVID-19 pandemic
Authors: Pat Price, Shandi E Barney
Journal: The Lancet Oncology (2020)

The COVID-19 pandemic is a huge challenge to health-care systems around the world. Expansion of respiratory and intensive care facilities and cancellation of non-urgent treatments is being done to combat this challenge. However, the impact on patients with cancer is an unintended detrimental consequence of these necessary changes that will persist well after the peak of the virus and for years to come. All aspects of the cancer pathway are being disrupted by the COVID-19 pandemic.1The Lancet OncologyCOVID-19: global consequences for oncology.Lancet Oncol. 2020; 21: 467Summary Full Text Full Text PDF PubMed Scopus (113) Google Scholar Inevitable delays in diagnosis will result in stage progression and, as a consequence, poorer outcomes. Delayed and interrupted treatment will affect patients' immediate treatment and survival, and the cumulative backlog will impose a strain on cancer services in the future. There is an urgent need for solutions to be initiated to mitigate these disturbances and reduce the number of avoidable cancer deaths. Radiotherapy is needed in 50% of patients with cancer and involved in 40% of cancer cures, but is often overlooked.2Borras JM Lievens Y Barton M et al.How many new cancer patients in Europe will require radiotherapy by 2025? An ESTRO-HERO analysis.Radiother Oncol. 2016; 119: 5-11Summary Full Text Full Text PDF PubMed Scopus (124) Google Scholar However, in this pandemic, with surgery, chemotherapy, and immunotherapy often being cancelled, radiotherapy is becoming a go-to cancer treatment option. Data from China show that patients with cancer who had COVID-19 who received radiotherapy did not develop severe disease more frequently than patients without cancer who had COVID-19.3Dai M Liu D Liu M et al.Patients with cancer appear more vulnerable to SARS-COV-2: a multi-center study during the COVID-19 outbreak.Cancer Discov. 2020; (published online April 28.)DOI:10.1158/2159-8290.CD-20-0422Crossref PubMed Scopus (1172) Google Scholar Many clinicians are concerned that abandoning evidence-based radiotherapy treatment will increase cancer deaths unnecessarily and propose that radiotherapy services should be reclassified as critical cancer services throughout this pandemic. However, treating patients with radiotherapy in this crisis has substantial logistical and IT challenges, with its multistep, multi-visit, technologically complex delivery, and space occupancy within a hospital. In response to this challenge, the Global Coalition for Radiotherapy was launched on April 8, 2020. This coalition links professionals, societies, agencies, and industry, with the aim of providing rapid communication and sharing of experience of radiotherapy delivery during the pandemic and outcome data, as well as developing technical and research solutions. The first digital meeting combined the advice of 41 radiotherapy professionals, societies, organisations, and industry from all over the world. First-hand experience of radiotherapy treatment during the crisis in Wuhan was heard, a call for a global radiotherapy data collection made, and radiobiological research discussed. Industry partners were stimulated to focus and share their IT and technology solutions to allow safe and more remote working and assist advanced technology solutions to be implemented rapidly. Radiotherapy is one of the most technologically complex medical disciplines and developments in software, technology, and engineering have provided innovations that will facilitate changes in working practice that are needed now and after the pandemic peak. However, years of global underinvestment in radiotherapy mean that many services are faced with a much more daunting challenge to rapidly introduce the available technology solutions and techniques. To help with these challenges, the Global Coalition for Radiotherapy will use its collective multidisciplinary voice to advocate for best practice of radiotherapy for patients in these challenging times and in the future, by leveraging existing work by all coalition organisations. The strength of the Global Coalition for Radiotherapy is its broad and inclusive membership, linking radiotherapy providers, professionals, advocacy groups, international societies, and industry. International COVID-19 radiotherapy publications and emerging guidelines are uploaded onto the website daily and can be communicated immediately within countries by social media. The website forum will facilitate individual real-time questions and the monthly digital meetings can identify and address ongoing and future strategic issues. Rapid and open communication of global experience and thinking will ensure that radiotherapy services can swiftly adapt and develop around the world. Radiotherapy services need to change. Innovations at this challenging time could change them for the better—permanently. We declare no competing interests.