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Daily Practice

COVID-19 Clinical Guidance

ASTRO has compiled a selection of resources for radiation oncology professionals. The resources were developed by clinical teams and based on the best available information at the time they were posted and may be outdated or superseded. Physicians, and their patients, must make the ultimate judgment regarding specific treatment decisions. They are not meant to replace clinical judgment, but to help treatment teams strengthen their clinical management of patients and support decision-making processes during the COVID-19 pandemic.

ASTRO Recommendation on COVID-19 Vaccination for Cancer Patients Receiving Radiation Therapy

Cancer patients may have an increased risk of contracting COVID-19 and more severe disease if infected. According to the Centers for Disease Control and Prevention (CDC), “Adults of any age with certain underlying medical conditions are at increased risk for severe illness from the virus that causes COVID-19. mRNA COVID-19 vaccines may be administered to people with underlying medical conditions provided they have not had a severe or immediate allergic reaction to any of the ingredients in the vaccine.” These guidelines also apply to cancer patients. The mRNA COVID-19 vaccines do not include any virus, and there is no risk of contracting the infection from the vaccine.

Patients who have cancer, as well as those who have received treatment for cancer, may be immune compromised, but these patients may still receive COVID-19 vaccines as long as there is no increased risk of reaction to any of the components of the vaccine. ASTRO encourages cancer patients who are actively receiving treatment such as radiation therapy to consult with their oncologists about the timing for vaccination, injection location and any unique considerations relevant for their treatments. Individuals with a prior history of cancer who are not in active treatment are encouraged to seek vaccination whenever it is made available to them.

Clinical Guidance

General

Radiotherapy Imaging: An Unexpected Ally in Fighting COVID 19 Pandemic
Boldrini, L et al, April 25, 2020

Low Dose Radiation Therapy for COVID-19 Pneumonia: A Double-Edged Sword
Kefayat et al, April 20, 2020

Johns Hopkins University Program in a Pandemic
April 6, 2020

Recommendations for Prioritization, Treatment and Triage of Breast Cancer Patients During the COVID-19 Pandemic
April 1, 2020

UW Radiation Oncology COVID-10 Clinical Care Approach
March 27, 2020

NICE COVID-19 rapid guideline: delivery of radiotherapy
March 28, 2020

Disease Specific

Head and Neck

ASTRO/ESTRO Practice Recommendations for Risk-adapted Head and Neck Cancer Radiotherapy During the COVID-19 Pandemic
April 9, 2020

Considerations for the Treatment of Oesophageal Cancer With Radiotherapy During the COVID-19 Pandemic
Jones, C.M. et al., April 9, 2020

Breast

International Guidelines on Radiation Therapy for Breast Cancer During the COVID-19 Pandemic
Coles, C.E. et al, May 2020

Breast Radiotherapy Under COVID-19 Pandemic Resource Constraints -- Approaches to Defer or Shorten Treatment From a Comprehensive Cancer Center in the United States
Braunstein et al, April 1, 2020

Lung

ASTRO/ESTRO Practice Recommendations for Lung Cancer Radiotherapy During the COVID-19 Pandemic
April 6, 2020

Prostate

Prostate Cancer Radiotherapy Recommendations in Response to COVID-19
Zaorsky, N.G. et al, April 1, 2020

Rectal

International Expert Consensus Statement Regarding Radiotherapy Treatment Options for Rectal Cancer During the COVID 19 Pandemic
Marijnen, C.A.M. et al, April 2, 2020

Treatment Approach in Locally Advanced Rectal Cancer During Coronavirus (COVID-19) Pandemic: Long Course or Short Course?
Felice et al, April 1, 2020

Other

ILROG Emergency Guidelines for Radiation Therapy of Hematological Malignancies
April 10, 2020

Sterilization Guidance

Duke: Reuse of N95 Respirators with Hydrogen Peroxide Vapor
March 29, 2020

Fox Chase Cancer Center N95 Reprocessing Plan
March 29, 2020

UW Radiation Oncology COVID-19 Approach Disease Site Prioritization Scheme
March 26, 2020

Hypofractionation has been demonstrated to be equally effective as standard conventional courses of radiation therapy in specific clinical situations. ASTRO supports the use of hypofractionated regimens in disease sites where the treating radiation oncologist determines it is a reasonable approach.

Radiation Therapy for the Whole-Breast
Smith, B.D. et al, 2018

Hypofractionation for Localized Prostate Cancer
Morgan, S.C., 2018

Tumor Radiobiology of SRS and SBRT
Brown, J.M., 2013

View additional resources shared by cancer centers.

Last updated: 1/26/2021 9:59:17 AM