Review of Radiotherapy Activity in Scotland, 2 Years Post COVID

L Grocutt; T Rowe; D Caldwell; A J Chalmers; A Rutherford; C Wilkinson; S M O'Cathail

doi:10.1016/j.clon.2025.103862

Review of Radiotherapy Activity in Scotland, 2 Years Post COVID

Clin Oncol (R Coll Radiol). 2025 May 9:44:103862. doi: 10.1016/j.clon.2025.103862. Online ahead of print.

Authors

L Grocutt¹, T Rowe², D Caldwell³, A J Chalmers⁴, A Rutherford⁵, C Wilkinson⁶, S M O'Cathail⁷

Affiliations

¹ CRUK RadNet Glasgow, University of Glasgow, Glasgow, United Kingdom; Department of Radiotherapy Physics, the Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom. Electronic address: laura.grocutt@glasgow.ac.uk.
² Department of Radiotherapy Physics, the Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom. Electronic address: Thomas.Rowe@gstt.nhs.uk.
³ NRS CRN-W, Radiotherapy Department, the Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom. Electronic address: Donna.Caldwell@ggc.scot.nhs.uk.
⁴ School of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom. Electronic address: Anthony.Chalmers@glasgow.ac.uk.
⁵ Department of Radiotherapy Physics, the Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom. Electronic address: Alasdair.Rutherford@ggc.scot.nhs.uk.
⁶ NRS CRN-W, Radiotherapy Department, the Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom. Electronic address: Chloe.Wilkinson@ggc.scot.nhs.uk.
⁷ School of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom. Electronic address: Sean.OCathail@glasgow.ac.uk.

PMID: 40543178
DOI: 10.1016/j.clon.2025.103862

Abstract

Aims: Now that the world has returned to normal following the COVID-19 pandemic, there are concerns that the pandemic has had a negative, ongoing effect on cancer care. This study aims to investigate the impact of the COVID-19 pandemic on radiotherapy services in Scotland.

Materials and methods: Detailed quantitative data of radiotherapy activity at our centre were collected from 01/04/2021-31/03/2023, which cover the second and third 'post-COVID' years. Differences in total/mean weekly radiotherapy courses, dose and fractionation patterns, and treatment intent for all treatment sites were compared to data from the year before the COVID-19 pandemic and the first year of the COVID-19 pandemic (01/04/2019-31/03/2021).

Results: Compared with the first year of the COVID-19 pandemic, the total number of radiotherapy courses increased from 6240 to 7899 (+32%) and 8188 (+35%) for the second and third years, respectively. Average weekly radiotherapy courses (AWRC) delivered increased from 120 (standard deviation [sd ± 15) during the COVID-19 pandemic to 152 (sd±15) and 157 (sd±19) in the two following years. In the two years post the COVID-19 pandemic, the total number of radical treatments increased from 5470 to 5912 (8.1%) and the total number of palliative treatments decreased from 2429 to 2206 (-9%). During the COVID-19 pandemic, a significantly greater reduction in radiotherapy utilisation was observed for females (3750-3156; -16%) than for males (3090-2839; -8%). In contrast, the two years post the COVID-19 pandemic have seen a significant increase in the number of women, with the total number of patients increasing to 4813 and 4860 (65-69%), receiving radiotherapy compared to male patients, with the total number of patients 3086 and 3256 (9-15%), respectively.

Conclusion: The two years post COVID-19 pandemic have seen a significant increase in radiotherapy activity compared to the first year of the COVID-19 pandemic and the year prior. The largest recoveries in radiotherapy delivery post the COVID-19 pandemic were observed in breast, cervical, rectal, and prostate cancer. Contrarily, a decrease in radiotherapy delivery was observed in patients with lung cancer. The increase in radiotherapy activity can likely be attributed to COVID-related suspensions of diagnostic tests, surgeries, and cancer screenings being reinstated.

Keywords: COVID-19; SARS-CoV-2; Scotland; UK; pandemic; radiotherapy.