The impact of the COVID-19 pandemic on radiotherapy services in England, UK: a population-based study

Katie Spencer*, Christopher M. Jones, Rebecca Girdler, Catherine Roe, Michael Sharpe, Sarah Lawton, Louise Miller, Philippa Lewis, Mererid Evans, David Sebag-Montefiore, Tom Roques, Rebecca Smittenaar, Eva Morris

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    75 Citations (Scopus)

    Abstract

    Background The indirect impact of the COVID-19 pandemic on cancer outcomes is of increasing concern. However, the extent to which key treatment modalities have been affected is unclear. We aimed to assess the impact of the pandemic on radiotherapy activity in England.

    Methods In this population-based study, data relating to all radiotherapy delivered for cancer in the English NHS, between Feb 4, 2019, and June 28, 2020, were extracted from the National Radiotherapy Dataset. Changes in mean weekly radiotherapy courses, attendances (reflecting fractions), and fractionation patterns following the start of the UK lockdown were compared with corresponding months in 2019 overall, for specific diagnoses, and across age groups. The significance of changes in radiotherapy activity during lockdown was examined using interrupted time-series (ITS) analysis.

    Findings In 2020, mean weekly radiotherapy courses fell by 19.9% in April, 6.2% in May, and 11.6% in June compared with corresponding months in 2019. A relatively greater fall was observed for attendances (29.1% in April, 31.4% in May, and 31.5% in June). These changes were significant on ITS analysis (p

    Interpretation Radiotherapy activity fell significantly, but use of hypofractionated regimens rapidly increased in the English NHS during the first peak of the COVID-19 pandemic. An increase in treatments for some cancers suggests that radiotherapy compensated for reduced surgical activity. These data will assist health-care providers in understanding the indirect consequences of the pandemic and the role of radiotherapy services in minimising these consequences. Copyright (C) 2021 Elsevier Ltd. All rights reserved.

    Original languageEnglish
    Pages (from-to)309-320
    Number of pages12
    JournalThe Lancet Oncology
    Volume22
    Issue number3
    DOIs
    Publication statusPublished - Mar 2021

    Bibliographical note

    Funding Information:
    No study-specific funding was provided for this analysis. Data for this analysis are based on patient-level information collected by the NHS, as part of the care and support of patients with cancer. The data are collated, maintained, and quality assured by the National Cancer Registration and Analysis Service, which is part of PHE. KS is funded through a University of Leeds University Academic Fellowship. CMJ is supported by a Wellcome Trust Clinical Research Fellowship (203914/Z/16/Z). EM's contribution was supported by Cancer Research UK (C23434/A23706), Health Data Research UK, and the National Institute for Health Research Oxford Biomedical Centre.

    Funding Information:
    No study-specific funding was provided for this analysis. Data for this analysis are based on patient-level information collected by the NHS, as part of the care and support of patients with cancer. The data are collated, maintained, and quality assured by the National Cancer Registration and Analysis Service, which is part of PHE. KS is funded through a University of Leeds University Academic Fellowship. CMJ is supported by a Wellcome Trust Clinical Research Fellowship (203914/Z/16/Z). EM's contribution was supported by Cancer Research UK (C23434/A23706), Health Data Research UK, and the National Institute for Health Research Oxford Biomedical Centre.

    Publisher Copyright:
    © 2021 Elsevier Ltd

    Fingerprint

    Dive into the research topics of 'The impact of the COVID-19 pandemic on radiotherapy services in England, UK: a population-based study'. Together they form a unique fingerprint.

    Cite this