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Expert panel recommends shorter radiotherapy treatment for bowel cancer during COVID-19

By University of Leeds
April 16, 2020

LEEDS, UK: In a recently published consensus statement, leading cancer experts have discussed radiotherapy treatment options for rectal cancer during the COVID-19-pandemic. In their paper, they recommended a one-week course of radiotherapy and to delay surgery for patients with bowel cancer.

The short course of treatment involves high-dose intensity radiation rather than five weeks of radiotherapy coupled with chemotherapy. Surgery, which normally happens one to two weeks after radiotherapy, can be safely delayed by up to 12 weeks, according to the expert panel.

This approach, based on the latest research evidence, will maintain the best chance of successfully treating the disease while at the same time reducing the side effects of treatment and the risks of COVID-19 infection.

The COVID-19 pandemic is a global emergency and we needed to work very quickly to identify changes that would benefit patients

Patients with bowel cancer are more susceptible to severe complications from COVID-19 because their immune system is weakened. Short-course radiotherapy avoids the need for chemotherapy, which further suppresses the immune system. It also means significantly fewer hospital appointments, allowing patients to maintain social distancing rules.

Prof. David Sebag-Montefiore, an academic clinical oncologist at the University of Leeds and leader of the expert panel, said:  “The COVID -19 pandemic is a global emergency and we needed to work very quickly to identify changes that would benefit patients. Our recommendations were published 20 days after our first meeting. This process normally takes many months, if not years.”

The panel comprised researchers who led the defining studies. Their research shows that surgery can be safely delayed by 12 weeks. The chances of successful treatment are maintained and post-operative side effects are reduced This allows surgery to be scheduled after the peak of the pandemic.

Our guidelines will result in a very substantial change in treatment across the globe

Prof. David Sebag-Montefiore. (Image: University of Leeds)

The recommendation to use short-course radiotherapy follows a major study, funded by the UK Medical Research Council and led by Sebag-Montefiore, which demonstrated the benefit of the one-week course of radiotherapy.

 “Our guidelines will result in a very substantial change in treatment across the globe. During the COVID -19 pandemic, our patients will benefit from the use of an effective, shorter and safer radiotherapy treatment,” Sebag-Montefiore concluded.

The journal pre-proof, titled “International expert consensus statement regarding radiotherapy treatment options forrectal cancer during the COVID 19 pandemic”, was published online on 30 March in Radiotherapy and Oncology.

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