PRESS-NEWS.org - Press Release Distribution
FREE PRESS RELEASES DISTRIBUTION

Dramatic changes to radiotherapy treatments due to COVID-19

2021-01-23
(Press-News.org) Dramatic changes were seen in the delivery of radiotherapy treatments for cancer during the first wave of the coronavirus pandemic in England.

Much shorter radiotherapy courses were delivered, treatments were delayed where it was safe to do so and some increases were seen in order to compensate for reduced surgical capacity.

Experts believe the changes reflect an impressive adaption of services by the NHS, and that the overall impact on cancer outcomes is likely to be modest.

The new research, led by the University of Leeds, with Public Health England and the Royal College of Radiologists, reveals that there was a decrease in radiotherapy treatment courses of 19.9% in April, 6.2% in May, and 11.6% in June 2020, compared with the same months the previous year.

These decreases equated to more than 3,000 fewer courses of radiotherapy between 23 March and 28 June 2020, than would have been expected*. However, the missed courses were likely to be due to postponement, where the risk of doing so was deemed low. In June though, it appears that the reduced number of courses may reflect a worrying fall in the number of patients being diagnosed with cancer.

The new study is the first to assess the impact of the pandemic on radiotherapy services in England and is published today in The Lancet Oncology. A rapid change in practice occurred for breast cancer treatments, enabled in part by the results of a UK trial published just as the pandemic struck, which showed a one-week course to be just as effective as a three-week course for many patients**.

Strikingly, the use of the shorter course of treatment went from just 0.2% of all breast cancer radiotherapy courses in April 2019, up to 60.0% of all courses in April 2020.

The switch to shorter courses of treatment was also seen in other types of cancer, and will have helped to keep patients safe and services running during the pandemic.

For some cancer types there was a significant increase in the use of radiotherapy courses compared to the previous year. There was an increase of 143.3% in curative radiotherapy for bladder cancer and 71.3% for oesophageal cancer in May, and 36.3% for bowel cancer in April.

These types of cancer are often treated with surgery. Radiotherapy offers an alternative curative treatment or means to safely delay, and it is likely these timely increases were delivered to keep patients safe when surgery was not possible due to the pandemic.

Radiotherapy guidance during pandemic

Around one in three people with cancer in the UK will receive radiotherapy as part of their treatment***. Radiotherapy can be used to try and cure a patient of their cancer, or to treat pain and other symptoms when curative treatment is not possible.

Treatments are often given using daily targeted doses of radiotherapy over a number of weeks. Every cancer is different, and radiotherapy courses vary depending on the type of cancer and the aim of treatment.

In March and April 2020, national and international recommendations were quickly published to ensure the safe and effective use of radiotherapy, as the first wave of COVID-19 hit the UK. The Royal College of Radiologists helped coordinate the writing and publication of many of these guidelines, with researchers from the University of Leeds contributing to many of these.

Lead author of the new study Dr Katie Spencer, University Academic Clinical Fellow at the University of Leeds and Consultant Clinical Oncologist at Leeds Teaching Hospitals NHS Trust, said: "Radiotherapy is a very important treatment option for cancer, and our study shows that across the English NHS there was a rapid shift in how radiotherapy was used.

"It is impressive to see that the data closely follows the guidelines published at the start of the pandemic. For cancers such as breast and bowel, shorter, more intensive treatments were delivered to provide similar outcomes for patients.

"Where treatment delay is safe, like in prostate cancer, delays were used to reduce the risk of coronavirus exposure. This was particularly important for older patients, who are more vulnerable to the virus.

"In other cases, such as head and neck, and anal cancers, we saw that the number of radiotherapy treatments hardly changed during the first wave. This was really reassuring, as we know that it is vital that these treatments are not delayed."

Treatments during the first wave

The researchers looked at the number of radiotherapy treatments taking place between February and June 2020 within the English NHS, taken from Public Health England's National Radiotherapy Dataset. They compared the number of radiotherapy courses, and their length, with the same time period in 2019, to look at the effects of the coronavirus pandemic and lockdown.

The largest reduction in treatments was seen for patients aged 70 and above (34.4% reduction in April 2020). This likely reflects concern where patient vulnerability to the risks of coronavirus outweighed the low risk expected from delaying treatment in some settings. For example, treatment for prostate cancer fell 77.0% in April 2020 compared to the previous year, and treatments for non-melanoma skin cancer fell 72.4% the same month.

Co-author Dr Tom Roques, Medical Director, Professional Practice for Clinical Oncology at the Royal College of Radiologists, said: "This research shows the incredible speed with which radiotherapy services within the NHS were able to adapt their treatment patterns to help protect patients with cancer, whilst coping with reduced surgical capacity due to the global pandemic.

"Despite the intense pressures on the NHS, it was able to effectively adapt radiotherapy treatments, finding alternative treatment options where possible, and continuing its world-leading standards of patient care.

"In the midst of the current COVID-19 surge, NHS capacity is under even greater stress. However, cancer teams are using all of the clinical experience and innovations from last year to ensure radiotherapy services continue to operate and provide the best care possible for patients."

The research team hope their findings will help healthcare providers to understand the indirect consequences of the pandemic and the role of radiotherapy services in minimising those effects.

This research involved contributions from University of Oxford, Velindre University NHS Trust, Norfolk & Norwich University Hospitals NHS Foundation Trust, and NHS England.

Fewer patients presenting

Dr Spencer, from the University of Leeds' Institute for Health Sciences and the Leeds CRUK Radiotherapy Centre of Excellence, said: "As the country emerged from the first lockdown in June, we saw that the number of patients receiving radiotherapy was still reduced compared to last year.

"The pandemic continues to cause severe disruption for cancer diagnosis and some national screening programmes. This has meant that fewer patients were diagnosed with cancer during the first wave of the pandemic and this is likely to have led to the persistent fall in treatments we see. We know that patients who have their cancer diagnosed early have a better chance of being cured so this is really worrying.

"If people have concerns about their health it is really important that they go and seek help. Radiotherapy services remain up and running and are ready to look after people, as always."

INFORMATION:

Notes to editors

For interview requests please contact press officer Ian Rosser from the University of Leeds on i.rosser@leeds.ac.uk or on 07712 389448.

The paper, titled 'The impact of the COVID-19 pandemic on radiotherapy services in England, UK: a population-based study from the National Radiotherapy Dataset', is published in The Lancet Oncology and will be available online once the embargo lifts: please follow this link: https://doi.org/10.1016/ S1470-2045(20)30743-9

* As part of this study, the research team created a model to forecast the expected number of radiotherapy courses in 2020. Comparing the actual data with the model showed there were 3,263 fewer courses of radiotherapy given between 23 March and 28 June 2020 than expected had the pandemic not occurred.

** The changes to the breast cancer radiotherapy treatments followed the publication of new guidelines and the results of a UK trial published just as the pandemic struck, which showed a one-week course to be just as effective as a three-week course for many patients. The guidelines are available on the Royal College of Radiologists website: https://www.rcr.ac.uk/sites/default/files/breast-cancer-treatment-covid19.pdf The paper, by Brunt et al., is available online in The Lancet: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30932-6/fulltext

*** One in three cancer patients in the UK receiving radiotherapy comes from data published by Borras et al. in 2015: https://pubmed.ncbi.nlm.nih.gov/25981052/

University of Leeds

The University of Leeds is one of the largest higher education institutions in the UK, with more than 38,000 students from more than 150 different countries, and a member of the Russell Group of research-intensive universities. The University plays a significant role in the Turing, Rosalind Franklin and Royce Institutes.

We are a top ten university for research and impact power in the UK, according to the 2014 Research Excellence Framework, and are in the top 100 of the QS World University Rankings 2021.

The University was awarded a Gold rating by the Government's Teaching Excellence Framework in 2017, recognising its 'consistently outstanding' teaching and learning provision. Twenty-six of our academics have been awarded National Teaching Fellowships - more than any other institution in England, Northern Ireland and Wales - reflecting the excellence of our teaching. http://www.leeds.ac.uk Follow University of Leeds or tag us in to coverage: Twitter Facebook LinkedIn Instagram



ELSE PRESS RELEASES FROM THIS DATE:

UTMB team proves potential for reducing pre-term birth by treating fetus as patient

2021-01-22
GALVESTON, Texas - The results of a study by researchers at the University of Texas Medical Branch may pave the way for a new medicine delivery system that could reduce the incidence of pre-term labor and premature birth by allowing physicians to treat the 'fetus as the patient'. The study has been published in Science Advances. It has long been suspected that pre-term labor is triggered by inflammation caused by a sick fetus. A new study by scientists at UTMB has proved the hypothesis by studying several important assumptions about the relationship between the health of a mother and her unborn child. According to Dr. Ramkumar Menon, ...

New technique builds super-hard metals from nanoparticles

New technique builds super-hard metals from nanoparticles
2021-01-22
PROVIDENCE, R.I. [Brown University] -- Metallurgists have all kinds of ways to make a chunk of metal harder. They can bend it, twist it, run it between two rollers or pound it with a hammer. These methods work by breaking up the metal's grain structure -- the microscopic crystalline domains that form a bulk piece of metal. Smaller grains make for harder metals. Now, a group of Brown University researchers has found a way to customize metallic grain structures from the bottom up. In a paper published in the journal Chem, the researchers show a method for smashing individual metal nanoclusters together to form solid macro-scale hunks of solid metal. Mechanical testing of the metals manufactured ...

Regulating the ribosomal RNA production line

Regulating the ribosomal RNA production line
2021-01-22
The enzyme that makes RNA from a DNA template is altered to slow the production of ribosomal RNA (rRNA), the most abundant type of RNA within cells, when resources are scarce and the bacteria Escherichia coli needs to slow its growth. Researchers used cryo-electron microscopy (cryo-EM) to capture the structures of the RNA polymerase while in complex with DNA and showed how its activity is changed in response to poor-growth conditions. A paper describing the research led by Penn State scientists appears January 22, 2020 in the journal Nature Communications. "RNA polymerase is an enzyme that produces a variety of RNAs using information encoded in DNA," said Katsuhiko Murakami, professor of biochemistry and molecular biology at Penn State and the leader of the research ...

ECMO/CRRT in the treatment of critically ill SARS-CoV-2 pneumonia patients

2021-01-22
In a new publication from Cardiovascular Innovations and Applications; DOI https://doi.org/10.15212/CVIA.2019.1267, Hai Zou and Shengqing Li from the Institute of Pulmonary and Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai, China consider ECMO/CRRT combined support in the treatment of critically ill SARS-CoV-2 pneumonia patients. The authors of this article explored the experience with, and complications of, extracorporeal membrane oxygenation (ECMO) combined with continuous renal replacement therapy (CRRT) for treatment of critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. The survival rate of patients with cardiopulmonary failure treated with ECMO/CRRT in whom conventional ...

Risk factors for intraoperative pressure injury in aortic surgery

2021-01-22
In a new publication from Cardiovascular Innovations and Applications; DOI https://doi.org/10.15212/CVIA.2019.1263, Yao Dong, Jun-E Liu and Ling Song from the Capital Medical University, Beijing, China consider risk factors for intraoperative pressure injury in aortic surgery. Intraoperative pressure injuries are some of the most significant health problems in clinical practice. Patients undergoing aortic surgery are at high risk of developing an intraoperative pressure injury, with an incidence much higher than that associated with other types of cardiac surgery. In this article the authors identify risk factors associated with an increased risk of intraoperative pressure injury in patients undergoing aortic ...

Predictive value of blood pressure, heart rate, and blood pressure/heart rate ratio in a Chinese subpopulation with vasovagal syncope

2021-01-22
In a new publication from Cardiovascular Innovations and Applications; DOI https://doi.org/10.15212/CVIA.2019.1266, Zhuzhi Wen, Jingying Hou, Zun Mai, Huifen Huang, Yangxin Chen, Dengfeng Geng and Jingfeng Wang from Sun Yat-sen University, Guangzhou, China and Guandong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China consider predictive value of blood pressure, heart rate, and blood pressure/heart rate ratio in a Chinese subpopulation with vasovagal syncope. Blood pressure, heart rate and ratios of blood pressure to heart rate in the titled position during the simplistic tilt test had predictive value with regard ...

A method for calculating optimal parameters of liquid chrystal displays developed at RUDN University

A method for calculating optimal parameters of liquid chrystal displays developed at RUDN University
2021-01-22
A professor from RUDN University together with his colleagues from Saratov Chernyshevsky State University and D. Mendeleev University of Chemical Technology of Russia developed a method for calculating the parameters of diffraction optical elements used in LCDs. In particular, the new technology can be used to expand the angle of view while preserving high resolution and color rendition. The results of the study were published in the Journal of The Society for Information Display. Each pixel on a display corresponds to a group of three light sources: red, green, and blue. When the brightness of all three diodes is the same, white light is produced; and by changing the share of each respective ...

No more needles for diagnostic tests?

No more needles for diagnostic tests?
2021-01-22
Blood draws are no fun. They hurt. Veins can burst, or even roll -- like they're trying to avoid the needle, too. Oftentimes, doctors use blood samples to check for biomarkers of disease: antibodies that signal a viral or bacterial infection, such as SARS-CoV-2, the virus responsible for COVID-19; or cytokines indicative of inflammation seen in conditions such as rheumatoid arthritis and sepsis. These biomarkers aren't just in blood, though. They can also be found in the dense liquid medium that surrounds our cells, but in a low abundance that makes it difficult to be detected. Until now. Engineers at the McKelvey School of Engineering at Washington University in St. Louis have developed a microneedle patch that can be applied to the skin, capture a biomarker of interest ...

A professor from RUDN University developed new liquid crystals

A professor from RUDN University developed new liquid crystals
2021-01-22
A professor from RUDN University together with his Indian colleagues synthesized and studied new dibenzophenazine-based liquid crystals that could potentially be used in optoelectronics and solar panels. The results of the study were published in the Journal of Molecular Liquids. Liquid crystals are an intermediate phase between a liquid and a solid body. They are ordered like regular chrystals but at the same time have a flow like liquids. It is this duality that allows them to be used in organic LEDs and LCDs. Unlike other liquid crystals, discotic ones (DLC) are capable of self-assembly into ordered structures. This makes them a promising material for industrial electronics, namely, for the production of displays. ...

Wet and wild: There's lots of water in the world's most explosive volcano

Wet and wild: Theres lots of water in the worlds most explosive volcano
2021-01-22
There isn't much in Kamchatka, a remote peninsula in northeastern Russia just across the Bering Sea from Alaska, besides an impressive population of brown bears and the most explosive volcano in the world. Kamchatka's Shiveluch volcano has had more than 40 violent eruptions over the last 10,000 years. The last gigantic blast occurred in 1964, creating a new crater and covering an area of nearly 100 square kilometers with pyroclastic flows. But Shiveluch is actually currently erupting, as it has been for over 20 years. So why would anyone risk venturing too close? Researchers from Washington University in St. Louis, including Michael Krawczynski, assistant professor of earth ...

LAST 30 PRESS RELEASES:

Sensing suns

When foams collapse (and when they don't)

Predicts the onset of Alzheimer's Disease (AD) using deep learning-based Splice-AI

Oahu marine protected areas offer limited protection of coral reef herbivorous fishes

'Explicit instruction' provides dramatic benefits in learning to read

Deep brain stimulation and exercise restore movement in ataxia

Atherosclerosis can accelerate the development of clonal hematopoiesis, study finds

Picture books can boost physical activity for youth with autism

Cancer: a new killer lymphocyte enters the ring

When using pyrite to understand Earth's ocean and atmosphere: Think local, not global

New insights into an ancient protein complex

Meteorites remember conditions of stellar explosions

Cerium sidelines silver to make drug precursor

Researchers identify characteristics of highest utilizers for mental health hospital services

Research reveals how bacteria defeat drugs that fight cystic fibrosis

Sensing robot healthcare helpers being developed at SFU

Agents of food-borne zoonoses confirmed to parasitise newly-recorded in Thailand snails

New tools find COVID patients at highest risk of mechanical ventilation and death

Exposure to diverse career paths can help fill labor market 'skills gap'

Engineering the boundary between 2D and 3D materials

Republican and Democratic voters agree on one thing--the need for generous COVID-19 relief

New study highlights importance of context to physical theories

Quantum quirk yields giant magnetic effect, where none should exist

Considering disorder and cooperative effects in photon escape rates from atomic gases

Blood tests offer early indicator of severe COVID-19, study says

New research finds exercise may help slow memory loss for people living with Alzheimer's dementia

Using neutron scattering to better understand milk composition

Unburdening China of cancer: Trend analysis to assist prevention measures

Measuring the tRNA world

Household transmission of SARS-CoV-2

[Press-News.org] Dramatic changes to radiotherapy treatments due to COVID-19