ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic

Abstract

The International Lymphoma Radiation Oncology Group (ILROG) guidelines for using radiation therapy (RT) in hematological malignancies are widely used in many countries. The emergency situation created by the COVID-19 pandemic may result in limitations of treatment resources. Furthermore, in recognition of the need to also reduce the exposure of patients and staff to potential infection with COVID-19, the ILROG task force has made recommendations for alternative radiation treatment schemes. The emphasis is on maintaining clinical efficacy and safety by increasing the dose per fraction while reducing the number of daily treatments. The guidance is informed by adhering to acceptable radiobiological parameters and clinical tolerability. The options for delaying or omitting RT in some hematological categories are also discussed.

Australian and New Zealand consensus statement on the management of lymphoma, chronic lymphocytic leukaemia and myeloma during the COVID‐19 pandemic

“…Six cycles of R‐CHOP with consolidation radiotherapy are comparable to dose‐adjusted R‐EPOCH, however, R‐CHOP is associated with less haematological toxicity (III) . Consider hypofractionation of radiotherapy in line with upcoming ILROG Emergency Guidelines or omission in older patients if the end of treatment PET is negative . Ultimately, the choice between these two regimens will be based on clinical and resource factors.…”

Preparation for the COVID-19 pandemic in the department of radiation oncology in the National Cancer Center Hospital in Tokyo

“…However, because the number of infected patients whose route of infection was unknown increased, our Prime Minister finally declared a state of emergency on 9 April. Several organizations or radiotherapy departments from severely affected regions published emergency guidelines or suggested solutions for the management of cancer patients during the global COVID-19 pandemic [2][3][4][5][6][7][8][9].…”

Managing patient flows in radiation oncology during the COVID-19 pandemic

“…The authors’ department performed accelerated and hypofractionated schemes for established treatment protocols more frequently, leading to increasing SRS initiation rates from 45.71 to 67.68% of first treatments of all fractions daily. This led to a reduced time per patient for completion of the desired treatment and was later recommended by Radiation Oncology Specialist Societies [ 4 , 15 , 18 , 20 , 29 , 30 ], for example for bone metastases (1 × 8 Gy and 5 × 4 Gy) and mild simultaneous integrated boost (SIB) hypofractionation for localized prostate cancer (pT1b–T3aN0M0), analogously to the phase III CHHip trial [ 2 ].…”