The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index; none of the 4 sources its claims cite is checked for support yet.
ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic
Open accessAbstract
The International Lymphoma Radiation Oncology Group (ILROG) guidelines for using radiation therapy (RT) in hematological malignancies are widely used in many countries. The emergency situation created by the COVID-19 pandemic may result in limitations of treatment resources. Furthermore, in recognition of the need to also reduce the exposure of patients and staff to potential infection with COVID-19, the ILROG task force has made recommendations for alternative radiation treatment schemes. The emphasis is on maintaining clinical efficacy and safety by increasing the dose per fraction while reducing the number of daily treatments. The guidance is informed by adhering to acceptable radiobiological parameters and clinical tolerability. The options for delaying or omitting RT in some hematological categories are also discussed.
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Claims the paper makes
0 of 4 cited sources checked · 0 supported · 0 flagged
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Radiobiological considerations and clinical experiences were used by the ILROG task force to generate the suggested altered dose and fractionation schedules described in Table 1”
§ ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic > Strategies > Shortening RT course
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“When the risk of severe outcomes from COVID-19 infection (for those aged ≥60 years and/or with serious underlying health conditions) outweighs the benefit of RT, omitting RT is to be considered in the following situations14, 15:”
§ ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic > Strategies > Omitting RT
What the sources say
- Not checked yetcites [14] National Comprehensive Cancer Network (NCCN) . B-cell lymphomas.2020. https://www.nccn.org/professionals/physician_gls/default.aspx. Accessed 2 January 2020.
- Not checked yetcites [15] National Comprehensive Cancer Network (NCCN) . Primary cutaneous lymphoma.2020. https://www.nccn.org/professionals/physician_gls/default.aspx. Accessed 2 January 2020.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“However, laboratory data suggest little to no shoulder on the linear-quadratic model of cell survival, leading to a large value of α/β.17”
§ ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic > Strategies > Shortening RT course
What the sources say
- Not checked yetcites [17] Aldridge, 1998, Explaining differences in sensitivity to killing by ionizing radiation between human lymphoid cell lines, Cancer Res
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The risks of acute and late toxicity to normal tissues associated with large dose per faction and higher EQD2 for α/β = 3 Gy are currently mitigated by the use of modern conformal RT techniques.”
§ ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic > Strategies > Shortening RT course
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Rests on an assumption: Modern technology provides steep dose gradients around the target tumor, leaving most surrounding normal tissues in the low-dose volume.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The risks are also mitigated by the low RT doses used in hematological malignancies, particularly the indolent types.”
§ ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic > Strategies > Shortening RT course
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“We therefore expect the biological effect of radiation on lymphoma cells, measured as equivalent dose in 2-Gy fractions (EQD2)18 to lie between EQD2 using α/β = 10 Gy and EQD2 = total dose.”
§ ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic > Strategies > Shortening RT course
What the sources say
- Not checked yetcites [18] Bentzen, 2012, Bioeffect modeling and equieffective dose concepts in radiation oncology–terminology, quantities and units, Radiother Oncol source
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
- Probably not a substantial claim. 2
- It may state two separate claims as one. 1
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The accuracy of the prediction of the α/β model may be less for the larger fraction sizes.”
§ ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic > Strategies > Shortening RT course
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, to mitigate clinical risk, we have used dose-per-fractionation regimens that many in the clinical community are already familiar with and know are well tolerated.”
§ ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic > Strategies > Shortening RT course
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The suggested hypofractionated schemes have little reduction of the total dose aiming to maintain the same level of tumor control.”
§ ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic > Strategies > Shortening RT course
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper relies on this without support.
The COVID-19 pandemic may cause limitations in treatment resources.
“The emergency situation created by the COVID-19 pandemic may result in limitations of treatment resources.”
The paper relies on this without support.
Resource limitations may reduce radiation therapy treatment capacity.
“Yet, limitations in resources, including space, equipment, and staff, may result in reduction of treatment capacity.”
The paper relies on this without support.
Radiation therapy can serve as a bridging measure that produces rapid and effective tumor control and delays the need for systemic therapy.
“There are also clinical situations in which RT can be used as a bridging measure, resulting in rapid and effective tumor control, delaying the need to initiate systemic therapy.”
The paper relies on this without support.
Giving additional chemotherapy to avoid radiation therapy may cause prolonged immunosuppression, which may be disadvantageous during a pandemic.
“However, if more chemotherapy needs to be given in order to omit RT, this may induce prolonged immunosuppression, which may, in many clinical situations, not be the best decision during a pandemic.”
The paper relies on this without support.
Hypofractionation always influences the effective dose for late effects.
“Hypofractionation will always influence the effective dose for late effects, so risks need to be carefully weighed.”
The paper relies on this without support.
The fractionation sensitivity of hematologic malignancies is underreported in clinical series.
“The fractionation sensitivity of hematologic malignancies is underreported in clinical series.”
The paper relies on this without support.
Modern technology provides steep dose gradients around the target tumor, leaving most surrounding normal tissues in the low-dose volume.
“Modern technology offers steep dose gradients around the target tumor with most of the surrounding normal tissues in the low-dose volume.”
The paper relies on this without support.
Hypofractionation has not been rigorously tested in prospective randomized trials for curative treatment of hematologic malignancies.
“Hypofractionation has, however, not been rigorously tested in prospective randomized trials in the curative treatment of hematologic malignancies, and, therefore, the treatment schedules proposed are recommended to apply only to the emergency situation of the COVID-19 pandemic.”
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“[57] In the palliative setting, patients should be offered the smallest number of fractions to minimize the need to attend the hospital and potential exposure to infection.”
Metadata
- Authors
- Yahalom, J., Dabaja, B. S., Ricardi, U., Ng, A., Mikhaeel, N. G., Vogelius, I. R., Illidge, T., Qi, S., Wirth, A., & Specht, L.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- The University of Texas MD Anderson Cancer Center (US)
- University of Turin (IT)
- Dana-Farber Cancer Institute (US)
- St Thomas' Hospital (GB)
- University of Copenhagen (DK)
- National Health Service (GB)
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- Peter MacCallum Cancer Centre (AU)
- Corresponding author
- Yahalom, Joachim
- ORCID
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2020-05-21
- Volume
- 135
- Issue
- 21
- Pages
- 1829-1832
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- PMC
- PMC7243146
- OpenAlex
- W3015535093
- Cited by
- 111
- References
- 21
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 10 · 2023: 8 · 2022: 17 · 2021: 22 · 2020: 40
- FWCI
- 7.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Blood (publishedVersion)
- PubMed Central (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion)
- Funders
- National Institute for Health and Care Research (NIHR200257)
- Topics
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advances in Oncology and Radiotherapy
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Keywords
- radiotherapy, hematologic malignancies, hypofractionated radiotherapy, dose per fraction, infection risk reduction, treatment delay, lymphoma, radiotherapy safety
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Humans, Lymphoma, Pneumonia, Viral, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Risk Factors, Time Factors, Coronavirus Infections, Hematologic Neoplasms, Pandemics
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