Sir — The insightful study by Grocutt et al. [1] captured our interest, as it highlighted a significant 10% decline in radical radiotherapy courses and a shift towards hypofractionated regimens during the first year of the COVID-19 pandemic in Scotland. While shedding light on the pandemic's indirect effects on radiotherapy services, the study also revealed unresolved issues that warrant careful attention.
First, and foremost, the successful completion of scheduled radiotherapy exerts a profound impact on the ultimate survival outcomes of cancer patients, regardless of whether the treatment is curative or palliative [2,3]. Although the adoption of hypofractionated radiotherapy may have contributed to treatment completion, the full extent of how COVID-19 lockdown measures affected critical patient outcomes, including quality of life and overall survival, remains to be comprehensively elucidated [1].
Furthermore, a recent report by Gaudio et al. [4] explored the impact of sociodemographic factors on radiotherapy interruptions in an urban population before and during the COVID-19 pandemic in the USA. Despite an overall decrease of 36% in patient volume, the rates of interruption remained stable. However, economically disadvantaged populations undergoing longer treatment courses (>20 fractions) faced an increased risk of significant interruptions (five or more breaks) [4].
Moreover, the COVID-19 pandemic has significantly affected the transportation landscape, particularly for vulnerable patient populations with an elevated risk of infection [5]. When evaluating the fluctuations in radiotherapy activity throughout the pandemic, it is crucial to consider the factors contributing to transportation delays or cancellations due to lockdown measures.
Given these concerns, future research should carefully examine the impact of the COVID-19 pandemic on radiotherapy interruption rates and long-term outcomes. We greatly appreciate the valuable insights provided by Grocutt and colleagues, as they enhance our understanding of the challenges and potential strategies to mitigate the pandemic's impact on radiotherapy services and patient outcomes.
Author Contributions
TCL was responsible for data curation and writing (original draft, review and editing). CXH was responsible for conceptualisation, Software, Validation and writing (original draft, review and editing). All authors contributed to the article and approved the submitted version.
Funding
None.
Conflicts of Interest
The authors declare no conflicts of interest.
Acknowledgments
The authors acknowledge the support for the COVID study (110293-E) provided by Far Eastern Memorial Hospital.
References
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