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• W3039893704 abstract "Since January 2020, the spread of the COVID-19 pandemic in China and, in the next weeks, in Italy and then in the rest of Europe and the world, has had an enormous impact on the organization, safety procedures and prescription behavior of the physicians in radiation oncology. The main concerns expressed in the numerous comments, letters and papers published in the last three months are (a) how to assure the normal supply of the radiotherapy treatments; (b) how to keep constant the number of Healthcare Workers (HCW); (c) how to identify radiotherapy (RT) patients SARS-CoV-2 positive; (d) how to protect HCW from the viral infection; (e) how to protect the patients from the infections; (f) how to reduce the postponing and the delay of RT start. In previous communications, the initial modifications of the clinical activity in a radiotherapy department in Southern Italy – an area with a relative of low incidence of infections – were described soon after the declaration of the pandemic [[1]Portaluri M. Tramacere F. Portaluri T. Gianicolo E.L.A. Southern Italy: How the supply of radiation therapy, patient outcomes, and risk to health care providers have changed during the COVID-19 pandemic.Adv Radiat Oncol. 2020; https://doi.org/10.1016/j.adro.2020.03.016Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar] and some criticism were addressed towards the safety recommendations of the national governmental and the scientific institutions, as they were contradictory and arguably inadequate to ensure patients’ and HCWs’ safety [[2]Portaluri M, Bambace S, Tramacere F, Errico A, Carbone S, Portaluri T. Staff and patients protection in radiation oncology departments during covid-19 pandemic https://www.astro.org/ASTRO/media/ASTRO/Daily%20Practice/PDFs/COVID-Portaluriet-al-2(ADRO).pdf.Google Scholar]. Many papers have been published with the aim to resume the Hypofractionated (HF) schedules which are considered more suitable for avoiding many visits to the hospital centre, for respecting the time between surgery and RT and thus reducing the risk of infection. Last 29 April, a search on Pubmed (www.pubmed.gov) based on the query radiotherapy + covid-19 gave 53 papers. Among these, we selected those regarding fractionation scenario. In Table 1, the HF schedules proposed in this pandemic period, from different countries, are summarized [3Thomson et al.Practice recommendations for risk-adapted head and neck cancer radiotherapy during the COVID-19 pandemic: an ASTRO-ESTRO consensus statement.Int J Radiat Oncol Biol Phys. 2020; Abstract Full Text Full Text PDF Scopus (142) Google Scholar, 4Braunstein et al.Breast radiation therapy under COVID-19 pandemic resource constraints-approaches to defer or shorten treatment from a comprehensive cancer center in the United States.Adv Radiat Oncol. 2020; Abstract Full Text Full Text PDF Scopus (83) Google Scholar, 5Coles et al.International guidelines on radiation therapy for breast cancer during the COVID-19 pandemic.Clin Oncol. 2020; 32: 279-281Abstract Full Text Full Text PDF PubMed Scopus (177) Google Scholar, 6Guckenberger et al.Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: an ESTRO-ASTRO consensus statement.Radiother Oncol. 2020; 146: 223-229Abstract Full Text Full Text PDF PubMed Scopus (123) Google Scholar, 7Tchelebi et al.Recommendations on the use of radiation therapy in managing patients with gastrointestinal malignancies in the era of COVID-19.Radiother Oncol. 2020; 148: 194-200Abstract Full Text Full Text PDF PubMed Scopus (36) Google Scholar, 8Romesser et al.Management of locally advanced rectal cancer during the COVID-19 pandemic: a necessary paradigm change at memorial Sloan Kettering Cancer Center.Adv Radiat Oncol. 2020; Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar, 9Marijnen et al.International expert consensus statement regarding radiotherapy treatment options for rectal cancer during the COVID 19 pandemic.Radiother Oncol. 2020; 148: 213-215Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar, 10Yahalom et al.ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic.Blood. 2020; Crossref PubMed Scopus (14) Google Scholar, 11Zaorsky et al.Prostate cancer radiotherapy recommendations in response to COVID-19.Adv Radiat Oncol. 2020; Abstract Full Text Full Text PDF PubMed Scopus (137) Google Scholar, 12Simcock et al.COVID-19: Global radiation oncology’s targeted response for pandemic preparedness.Clin Transl Radiat Oncol. 2020; 22: 55-68Abstract Full Text Full Text PDF PubMed Scopus (165) Google Scholar, 13Combs et al.First statement on preparation for the COVID-19 pandemic in large German Speaking University-based radiation oncology departments.Radiat Oncol. 2020; Crossref Scopus (51) Google Scholar, 14Yerramilli et al.Palliative radiotherapy for oncologic emergencies in the setting of COVID- 19: approaches to balancing risks and benefits.Adv Radiat Oncol. 2020; Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar]. They are well known schedules, already used with different motivations: (a) short life expectancy or poor general conditions; (b) advanced age and logistic problems in reaching the RT hospital; (c) radiobiological evidence in tumors with higher sensitivity than conventional fraction dose (breast, prostate); (d) the need to reduce inpatient stay for palliative treatments; (e) the increasing demand of >RT, in countries with universal access to health services, produced a relative shortage of machines and an increasing of waiting times.Table 1Resume of HF schedules suggested during Covid-19 pandemic. Abbreviations: PBI: partial breast irradiation; WBRT: whole breast irradiation; PMRT: post mastectomy radiotherapy; RNI: regional node irradiation; SIB: simultaneous integrated boost; NSCLC: non small cell lung carcinoma; SBRT: stereotactic body radiotherapy; CRM: circumferential resection margin; TME: total mesorectal excision; SCRT: short course radiotherapy; HL: Hodgkin Lymphoma; NHL: Non-Hodgkin Lymphoma; NK-T: natural killer-T; H&N: head and neck; IR-HR: Intermediate and High risk; WBRT: whole brain radiotherapy; BID: twice daily; GBM: glioblastoma multiforme; SVC syndrome: superior vena cava syndrome; TMZ: temozolomide; IORT: intraoperative radiotherapy; HPV: human papilloma virus; KPS: Karnofsky performance status; SRS: stereotactic radiosurgery; DCIS: ductal carcinoma in situ; SCLC: small cell lung carcinoma.Author (ref)CountrySite/GeneralFractionation schedulesThomson [3]Thomson et al.Practice recommendations for risk-adapted head and neck cancer radiotherapy during the COVID-19 pandemic: an ASTRO-ESTRO consensus statement.Int J Radiat Oncol Biol Phys. 2020; Abstract Full Text Full Text PDF Scopus (142) Google ScholarInternationalH&NScenario 1-early COVID-19 pandemic-risk mitigation: agreement use of conventional or midly hypofractionated radiotherapy with concomitant chemotherapy:(52%: 2–2.2 Gy/f, 21% 2.2–2.4 Gy/f, 24% 2.4–2.6 Gy/f, 3% 2.6–2.8 Gy/f)palliative RT:30 Gy/10f (17%), 44.4 Gy/12f (17%), 20 Gy/5f (13%), 32 Gy/4f (7%) 8 Gy/1f (4%)Scenario 2-later COVID-19 pandemic -severely reduced RT resources: hypofractionation is strongly recommended.Oropharinx p16 neg pT2N2bM0: 2.14–3 Gy/f (70%)Larynx T1bN0M0 (glot): 2.41–3.2 Gy/f (70%)Larynx T3N1M0: 2.21–2.8 Gy/f (80%)Hypopharinx palliative: various- 8 Gy/1f 20 Gy/5fBraunstein [4]Braunstein et al.Breast radiation therapy under COVID-19 pandemic resource constraints-approaches to defer or shorten treatment from a comprehensive cancer center in the United States.Adv Radiat Oncol. 2020; Abstract Full Text Full Text PDF Scopus (83) Google ScholarNY-USABreastPBI: 30 Gy/5f every other day (preferred) or daily (acceptable) or 40 Gy/10 dailyWBRT: 26 Gy/5 daily +/- 5.2 Gy × 1 boost or 40 Gy/15 daily or 42.4 Gy/16 dailyPM-RT: 42.56 Gy/16fBREAST AND RNI: 42.56 Gy/16f with SIB on tumor bed 48 Gy/16f or 40 Gy/15f with SIB on tumor bed 48 Gy/15fColes [5]Coles et al.International guidelines on radiation therapy for breast cancer during the COVID-19 pandemic.Clin Oncol. 2020; 32: 279-281Abstract Full Text Full Text PDF PubMed Scopus (177) Google ScholarInternationalBreastWBRT, node negative:28-30 Gy/5f (weekly) or 26 Gy/5f (daily) (FAST and FAST Forward trials, respectively)WBRT, node positive:40.05 Gy/15fPBI:28.5–6 Gy/5f (over 1–2 weeks)Guckenberger [6]Guckenberger et al.Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: an ESTRO-ASTRO consensus statement.Radiother Oncol. 2020; 146: 223-229Abstract Full Text Full Text PDF PubMed Scopus (123) Google ScholarEurope/USALungNSCLC Stage I:45–54 Gy/3f or 48 Gy/4f (standard) or 30–34 Gy/1fNSCLC Stage III:Exclusive RT: 60 Gy/15–20f or 60–66 Gy/24–30f or 55 Gy/20fSequential RTCT: 60–66 Gy/24–30f or 55–60 Gy/20f or 60 Gy/15fPalliative NSCLC:30 Gy/10f (standard) or 20 Gy/5f or 17 Gy/2f or 8–10 Gy/1f (strong recommended)Tchelebi [7]Tchelebi et al.Recommendations on the use of radiation therapy in managing patients with gastrointestinal malignancies in the era of COVID-19.Radiother Oncol. 2020; 148: 194-200Abstract Full Text Full Text PDF PubMed Scopus (36) Google ScholarUSA, EuropeGIEsophagus:definitive RT followed by CHT: 40 Gy/15fdefinitive exclusive RT: 50 Gy/16 or 20fpalliative RT: 30 Gy/10f or 6–8 Gy/1f (pain or bleeding) or 20 Gy/5f (dysphagia)Stomach:palliative RT: 6–8 Gy/1fLiver:16–30 Gy/1–3f or 48–60 Gy/3–5f (SBRT)Cholangiocarcinoma:67.5 Gy/15f or 30–60 Gy/3–6f (post induction CHT)Pancreas:Bordeline resectable: 30–33 Gy/5f (SBRT) or 25 Gy/5f or 30 Gy/10f withconcurrent gemcitabineInoperable: 30–40 Gy/5f (in case of response post CHT)Rectum:locally advanced operable: preoperative 25 Gy/5f (after induction CHT)inoperabile: 52 Gy/20fRomesser [8]Romesser et al.Management of locally advanced rectal cancer during the COVID-19 pandemic: a necessary paradigm change at memorial Sloan Kettering Cancer Center.Adv Radiat Oncol. 2020; Abstract Full Text Full Text PDF PubMed Scopus (28) Google ScholarNY-USARectumLocally advanced (also low-located, close CRM): 25 Gy/5f (SCRT) delay surgeryMarijnen [9]Marijnen et al.International expert consensus statement regarding radiotherapy treatment options for rectal cancer during the COVID 19 pandemic.Radiother Oncol. 2020; 148: 213-215Abstract Full Text Full Text PDF PubMed Scopus (57) Google ScholarInternationalRectumESMO rectal cancer guidelinesIntermediate group (if good TME cannot be assured): 25 Gy/5f (SCRT)Locally advanced rectal cancer: 25 Gy/5f (SCRT delay surgery)Advanced group: pre-operative CRT or 25 Gy/5f (SCRT followed by neo-adjuvant chemotherapy)Yahalom (ILROG) [10]Yahalom et al.ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic.Blood. 2020; Crossref PubMed Scopus (14) Google ScholarInternationalHematological malignanciesAggressive NHL,chemosensitive: 25 Gy/5f or 27 Gy/9fAggressive NHL,chemorefractory: 30 Gy/6fLocalized aggressive NHL, exclusive RT: 36–39 Gy/12–13fIndolent lymphoma, limited stage: 4 Gy/1f or 20 Gy/5fNK/T-cell lymphoma: 36 Gy/9fCutaneus T cell lymphoma: 8–12 Gy/2–3fSolitary bone plasmocitoma or solitary extramedullary plasmocitoma: 30 Gy/6f (non spine/H&N site) and 36 Gy/12f (spine/H&N site)Palliation:symptomatic aggressive: 25 Gy/5fZaorsky [11]Zaorsky et al.Prostate cancer radiotherapy recommendations in response to COVID-19.Adv Radiat Oncol. 2020; Abstract Full Text Full Text PDF PubMed Scopus (137) Google ScholarUSA-UKProstateIR/HR localized: 5 to 7f (SBRT) (v. 2020 NCCN guidelines) or 60–62 Gy/20fpost-prostatectomy: 52.5 Gy/20foligometastatic: 1 or 3 fractions (SBRT)low volume M1: 3–5 fractions (SBRT) or 36 Gy/6f (STAMPEDE)Simcock [12]Simcock et al.COVID-19: Global radiation oncology’s targeted response for pandemic preparedness.Clin Transl Radiat Oncol. 2020; 22: 55-68Abstract Full Text Full Text PDF PubMed Scopus (165) Google ScholarUSA, UK, ItalyGeneralPalliation:painful bone metastases (no fracture) +/− spinal cord compression: 6–10 Gy/1fbone metastases (fracture/surgery): 20 Gy/5fbrain metastases (SRS) 15–20 Gy/1fpalliative WBRT: 20 Gy/5fpalliative WBRT (poor prognosis): 12 Gy/2fesophageal bleeding/dysphagia: 12 Gy/4f (BID) or 15 Gy/3f or 18 Gy/3f (day 0,7,21)GBM (poor prognosis): 25 Gy/5fPalliative H&N: 30–36 Gy/5–6f (2f/week)Palliative H&N: 18–24 Gy/3f (day 0,7,21)SCV syndrome/lung cancer: 8–10 Gy/1f or 17 Gy/2f (1 week)Low grade Lymphoma: 4 Gy/1fPelvic/GI bleeding 20–24 Gy/5–6f or 18 Gy/4f (BID) or 14,8 Gy/4f (BID) (repeatable for a total dose of 44.4 Gy, in 3 courses) or 18–24 Gy/3 (Day 0,7,21)Radical RT:GBM (age > 65):40.05 Gy/15f + TMZBladder (cT2-4aN0,RTCT):55 Gy/20fBreast:PBI-early stage: 30 Gy/5f or 38.5 Gy/10f (BID)PBI-early stage (IORT): 20 Gy/1fWBRT, N0-early stage: 28.5 Gy/5fWBRT, +/- LN-early stage: 26 Gy/5fWBRT, + LNs: 40.05 Gy/15fChest wall: 40.05 Gy/15f or 43.5 Gy/15fWhole breast/Chest wall (>70y): 30–37.5 Gy/6f (weekly)H&N:HPV + definitive-localized: 60 Gy/30fDefinitive: 66 Gy/33f (6f/week)Lung:N0, medically inoperable (T1-T2, peripheral): 30–34 Gy/1f or 54 Gy/3f (SBRT)Locally advanced NSCLC (conc RTCT): 55–57.5 Gy/ 22–23fNSCLC (sequ RTCT): 54–60 Gy/ 18–20fNSCLC N+ (exclusive RT): 60 Gy/15fSCLC (RTCT): 40.05–42 Gy/15fPancreas:locally advanced: 25–50 Gy/5fProstate:any risk: 60 Gy/20fIR-HR, prostate only: 42.7 Gy/7fLR-IR, prostate only: 36.25–40 Gy/5f (SBRT)HR or M1 (>75y or 70y with comorbidities): 36 Gy/6fPost-prostectomy, fossa only: 52.4 Gy/20f or 62.5 Gy/25fRectum:cT3-4 preop-RT: 25 Gy/5fCombs [13]Combs et al.First statement on preparation for the COVID-19 pandemic in large German Speaking University-based radiation oncology departments.Radiat Oncol. 2020; Crossref Scopus (51) Google ScholarGermanyGeneralGBMKPS 100–80; >60-65y: 40.05 Gy/15f + TMZKPS < 60; 25 Gy/5f (no TMZ)Brain Metastases1–10 mts: good KPS: 18–20 Gy/1f (SRS)Post op: 35 Gy/7f or SRSLife expectancy > 3 months: 20 Gy/5f (WBRT)Meningeoma:WHO 1: 25 Gy/5fBreastDCIS: 40.05 Gy/15f (omit RT in case of low risk)Invasive: 40.05 Gy/15f or 26 Gy/5f (omit RT in case of low risk)N+: 40.05 Gy/15fPostmastectomy (Hypofractionation if not implant): 40.05 Gy/15f or 43.5 Gy/15fPBI: 38.5 Gy/10f (BID) or 30 Gy/5f or or 28.5 Gy/5f (weekly) or 26 Gy/5f (daily)PBI (IORT): 20 Gy/1fLungNSCLC stage I: 45 Gy/3f or 60 Gy/8f or 34 Gy/1fNSCLC stage III: 66 Gy/24fSCLC limited stage: 40.05 Gy/15fProstateIR/HR: 60 Gy/20fIR/HR < 75y:42.7 Gy/7fAdjuvant/salvatage: 52.5 Gy/20fPalliative RT:bone mets: 8 or 10 Gy/1f or 20 gy/5f or 21 Gy/3fH&N: QUADshot:14 Gy/4f (BID), Q4 weeks interval x2 timesbleeding: 8 Gy/1foligometastatic: SBRT (1–5f)Yerramilli [14]Yerramilli et al.Palliative radiotherapy for oncologic emergencies in the setting of COVID- 19: approaches to balancing risks and benefits.Adv Radiat Oncol. 2020; Abstract Full Text Full Text PDF PubMed Scopus (39) Google ScholarUSAPalliationBrain metastases:WBRT: 20 Gy/5fCord compression:8 Gy/1fTumor bleeding:14.8 Gy × 4f (BID) or 20 Gy × 5fSVC syndrome/Airway Obstruction17 Gy/2f (weekly) or 20 Gy × 5fBone metastases:8 Gy/1f Open table in a new tab Evidence-based decisions are a cornerstone also in medical sciences, at least at theoretical; its matching in the practices is however, sometimes, difficult to detect. For instance, point e) of the motivations for prescribing HF schedules, in Italy it is difficult to find it in a private setting (also when the private structure supplies radiotherapy on behalf of Health Public Service (HPS)) because reimbursement is on daily session basis. Recently, in the era of dynamic conformational techniques, the use of HF schedule has become more diffuse, also in the private structures, because they obtain in some region – the HPS is regional in Italy – a better reimbursement. During a pandemic, it may happen the occurrence of fault lines in medicine. One of these is the “willingness on the part of clinicians to abandon the prime dictum of medicine, to do no harm, and rush into treatments that not only may be useless but may well be dangerous. [[15]Joannidis J.P.A. Stuart M.E. Brownlee S. Strite S.A. How to survive the medical misinformation mess.Eur J Clin Invest. 2017; 47: 795-802Crossref PubMed Scopus (71) Google Scholar] The fact is, most physician are not trained to recognize good science from bad. Nor do they have the time to analyze every study, and too many are willing to ignore the need for reliable evidence when fear sets in” [[16]Lenzer J. Brownlee S. Pandemic science out of control.Issues Sci Technol. 2020; Google Scholar]. Are we going to his pitfall? Some fractionations in Head & Neck tumors, in a scenario where the RT resources are severely reduced, are quite anecdotic and based only on the consensus and preference of the physician [[3]Thomson et al.Practice recommendations for risk-adapted head and neck cancer radiotherapy during the COVID-19 pandemic: an ASTRO-ESTRO consensus statement.Int J Radiat Oncol Biol Phys. 2020; Abstract Full Text Full Text PDF Scopus (142) Google Scholar]. While for breast [[5]Coles et al.International guidelines on radiation therapy for breast cancer during the COVID-19 pandemic.Clin Oncol. 2020; 32: 279-281Abstract Full Text Full Text PDF PubMed Scopus (177) Google Scholar], in stage I NSLC [[4]Braunstein et al.Breast radiation therapy under COVID-19 pandemic resource constraints-approaches to defer or shorten treatment from a comprehensive cancer center in the United States.Adv Radiat Oncol. 2020; Abstract Full Text Full Text PDF Scopus (83) Google Scholar], rectum [8Romesser et al.Management of locally advanced rectal cancer during the COVID-19 pandemic: a necessary paradigm change at memorial Sloan Kettering Cancer Center.Adv Radiat Oncol. 2020; Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar, 9Marijnen et al.International expert consensus statement regarding radiotherapy treatment options for rectal cancer during the COVID 19 pandemic.Radiother Oncol. 2020; 148: 213-215Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar], prostate [[11]Zaorsky et al.Prostate cancer radiotherapy recommendations in response to COVID-19.Adv Radiat Oncol. 2020; Abstract Full Text Full Text PDF PubMed Scopus (137) Google Scholar], the schedules are supported by clinical trials, for some other schedules, such as some palliative one in glioblastoma [[10]Yahalom et al.ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic.Blood. 2020; Crossref PubMed Scopus (14) Google Scholar] or whole breast over 70-year [[12]Simcock et al.COVID-19: Global radiation oncology’s targeted response for pandemic preparedness.Clin Transl Radiat Oncol. 2020; 22: 55-68Abstract Full Text Full Text PDF PubMed Scopus (165) Google Scholar], their efficacy is still to be proved. At the onset of the pandemic, many treatments were postponed by the patients themselves or by the RT departments to minimize the number of the visits in the RT centers to the urgent and binding cases [[1]Portaluri M. Tramacere F. Portaluri T. Gianicolo E.L.A. Southern Italy: How the supply of radiation therapy, patient outcomes, and risk to health care providers have changed during the COVID-19 pandemic.Adv Radiat Oncol. 2020; https://doi.org/10.1016/j.adro.2020.03.016Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar]. So this decision could have theoretically impacted on the outcomes of some treatments. HF RT should be delivered only where solid scientific evidence is available, while some shortest courses in palliative setting likely are unuseful and therefore it would be better to deny them. In a palliative setting, the pandemic will allow us, perhaps, to avoid inappropriate therapy to some patients. Another aspect regards the patient’s consciousness. About ten years ago, when we started HF schedule of 15 fractions, after a breast conservative surgery with the publication of START trials [17START Trialists' Group, Bentzen SM, Agrawal RK, Aird EG, Barrett JM, Barrett-Lee PJ, et al., The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomized trial. Lancet. 2008;371:1098-107.Google Scholar, 18START Trialists' Group, Bentzen SM, Agrawal RK, Aird EG, Barrett JM, Barrett-Lee PJ, et al. The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet Oncol. 2008;9:331-41.Google Scholar], a strong argue with a patient occurred because she was concerned that our proposal to shorten the treatment time was due to the willingness to reduce the waiting times, rather than to work more and harder to treat all patients with the best schedules. It is now more frequent to meet patients who ask us to be treated in 5 fractions [[9]Marijnen et al.International expert consensus statement regarding radiotherapy treatment options for rectal cancer during the COVID 19 pandemic.Radiother Oncol. 2020; 148: 213-215Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar]. “Therefore, efforts should focus on making healthcare professionals, more sensitive to the limitations of the evidence, training them to do critical appraisal, and enhancing their communication skills so that they can effectively summarize and discuss medical evidence with patients to improve decision-making” [[15]Joannidis J.P.A. Stuart M.E. Brownlee S. Strite S.A. How to survive the medical misinformation mess.Eur J Clin Invest. 2017; 47: 795-802Crossref PubMed Scopus (71) Google Scholar]. We hope that the pandemic will not lead us to join to HF schedules uncritically, driven only by the urgency of the moment and let us time to discriminate what is solid and what is weak. The need of respecting the timing [[19]Nagar H. Formenti S.C. Cancer and COVID-19 — potentially deleterious effects of delaying radiotherapy.Nat Rev Clin Oncol. 2020; https://doi.org/10.1038/s41571-020-0375-1Crossref PubMed Scopus (54) Google Scholar] cannot be harmful for our patients and the lack of administrative support by means of delivery of adequate protections and timely staff recruitment cannot be changed by bad RT treatments. No funding." @default.
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• W3039893704 title "Hypofractionation in COVID-19 radiotherapy: A mix of evidence based medicine and of opportunities" @default.
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