NICE has published its second set of rapid COVID-19 guidelines which cover the provision of radiotherapy services and bone marrow transplant during the COVID-19 pandemic.
The NICE guidelines provide clinicians with advice on modifying care to reduce patients’ exposure to COVID-19 and how to balance the risks and benefits of treatment during the pandemic.
COVID-19 rapid guideline: delivering radiotherapy
The guideline on delivering radiotherapy recommends avoiding treatment if the evidence suggests there will be little to no benefit or if an alternative treatment is available, to defer radiotherapy if clinically appropriate, and if radiotherapy treatment is unavoidable, to use the shortest safe form of treatment.
Changing treatment schedules or interrupting treatment should be discussed with patients, their families and carers.
COVID-19 rapid guideline: bone marrow transplant
The guideline on bone marrow transplant advises clinicians to consider both the severity of the disease and the post-transplant risks of COVID-19 when deciding on treatment plans.
For patients who are due to receive an allogenic transplant (using stem cells from a donor), it recommends that clinicians defer most non-urgent cases and patients with chronic blood cancers, until the risks associated with the COVID-19 pandemic have passed.
Treatment decisions should be made by a multidisciplinary team that considers each patient on an individual basis and the reasoning behind each decision should be recorded.
These guidelines have been developed to maximise patient safety whilst making the best use of NHS resources and protecting staff from infection. The guidelines have been developed using the interim process and methods for developing rapid guidelines on COVID-19 and recommendations are based on evidence and expert opinion. Because NICE is using a different approach in order to develop these guidelines quickly to support frontline NHS staff, it will be reviewing them each week as new evidence, policy and practice emerges.