Clinician attitudes to using low dose radiotherapy to treat COVID-19 lung disease

Hanna, Catherine R.; Robb, Kathryn A.; Blyth, Kevin G.; Jones, Robert J.; Chalmers, Anthony J.

Introduction Current treatments for COVID-19 lung disease have limited efficacy. Low dose radiotherapy (LDRT) has received both interest and criticism as a potential treatment for this condition. In this qualitative study we explored clinicians’ perspectives in order to identify barriers to testing LDRT in clinical trials and implementing it in clinical practice. Methods Semi-structured interviews were undertaken with six clinicians from three medical disciplines. Interviews were recorded, transcribed verbatim and analysed thematically, using a framework approach. Common themes regarding barriers to using LDRT for COVID-19 lung disease were identified from the data. Results Three categories of barriers emerged: i) the potential to do harm to the patient, including difficulty in predicting harm and lack of existing data to inform quantification of risks; ii) the feasibility of trialling this novel treatment strategy in the clinical setting, in particular patient selection and buy-in from relevant clinician groups; and iii) the logistics of delivering the treatment, in particular risks of transmission to other patients and resources required for patient transfer. Conclusions This study identified several barriers that may impede the evaluation and subsequent implementation of LDRT as a treatment for COVID-19 lung disease, from the perspectives of clinicians in three relevant specialties. By documenting and articulating these concerns, we hope to enhance discussion of why these barriers exist, and enable them to be addressed in a proactive manner in order to facilitate research into the potential benefits of radiation treatment for patients with COVID-19 lung disease.