New research has revealed ‘dramatic changes’ in the delivery of radiotherapy treatments for cancer during the first wave of the COVID-19 pandemic in England.

The study – led by the University of Leeds with Public Health England and the Royal College of Radiologists – is the first to evaluate the impact of the pandemic on radiotherapy services in England.

Researchers discovered that the use of much shorter radiotherapy courses increased – in particular for breast cancer patients.

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

The change to shorter courses of treatment was also observed in other types of cancer, with clinicians likely making the switch to keep patients safe and services running during the pandemic.

According to the researchers, this change was made possible in part by results of a UK trial published soon before the pandemic, which showed that a one-week course is just as effective as a three-week treatment course for many breast cancer patients.

In addition, the new research found there was a 19.9% decrease in radiotherapy treatment courses in April, 6.2% in May and 11.6% in June – compared with the same months in 2019.

The largest reductions in radiotherapy treatments was observed for patients aged 70 years and above – reflecting a 34.4% decrease in April 2020.

According to the researchers, this most likely reflects concerns that patient vulnerability to the risks of COVID-19 outweighed the low risk expected from delaying treatment in some settings.

“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,” said Tom Roques, co-author of the study and medical director, Professional Practice for Clinical Oncology at the Royal College of Radiologists.

“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,” he added.