Institute of Cancer Sciences, University of Glasgow, Glasgow, Scotland; CRUK Clinical Trials Unit, Glasgow, Scotland.
Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Int J Radiat Oncol Biol Phys. 2021 Mar 15;109(4):886-890. doi: 10.1016/j.ijrobp.2020.12.003. Epub 2020 Dec 10.
Current treatments for coronavirus disease 2019 (COVID-19) lung disease have limited efficacy. Low-dose radiation therapy (LDRT) has received both interest and criticism as a potential treatment for this condition. In this qualitative study we explored clinicians' perspectives to identify barriers to testing LDRT in clinical trials and implementing it in clinical practice.
Semistructured interviews were undertaken with 6 clinicians from 3 medical disciplines. Interviews were recorded, transcribed verbatim, and analyzed thematically, using a framework approach. Common themes regarding barriers to using LDRT for COVID-19 lung disease were identified from the data.
Three categories of barriers emerged: (1) the potential to do harm to the patient, including difficulty in predicting harm and lack of existing data to inform quantification of risks; (2) the feasibility of trialing this novel treatment strategy in the clinical setting, in particular trial design and recruitment, patient selection and buy-in from relevant clinician groups; and (3) the logistics of delivering the treatment, in particular risks of transmission to other patients and resources required for patient transfer.
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 3 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 to facilitate research into the potential benefits of radiation treatment for patients with COVID-19 lung disease going forward.
目前针对 2019 年冠状病毒病（COVID-19）肺部疾病的治疗方法疗效有限。低剂量辐射疗法（LDRT）作为一种潜在的治疗方法受到了关注和批评。在这项定性研究中，我们探讨了临床医生的观点，以确定在临床试验中测试 LDRT 和将其应用于临床实践的障碍。
对来自 3 个医学专业的 6 名临床医生进行了半结构式访谈。对访谈进行了录音、逐字记录，并采用框架方法进行了主题分析。从数据中确定了使用 LDRT 治疗 COVID-19 肺部疾病的障碍的共同主题。
出现了 3 个类别的障碍：（1）对患者造成伤害的潜在风险，包括难以预测伤害和缺乏现有数据来量化风险；（2）在临床环境中试用这种新型治疗策略的可行性，特别是试验设计和招募、患者选择以及相关临床医生群体的认同；（3）提供治疗的后勤问题，特别是对其他患者的传播风险和患者转移所需的资源。
本研究从 3 个相关专业的临床医生的角度确定了几个可能阻碍 LDRT 作为 COVID-19 肺部疾病治疗方法进行评估和后续实施的障碍。通过记录和阐明这些关注点，我们希望加强对这些障碍存在原因的讨论，并能够以积极主动的方式解决这些障碍，以促进对 COVID-19 肺部疾病患者进行辐射治疗的潜在益处的研究。
