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Patterns of radiation therapy during the COVID-19 pandemic: Results from the Multicenter, Cross-Sectoral Registry of the German National Pandemic Cohort Network (NAPKON).
Radiation 6:13 (2026)
Background: Cancer patients receiving or having received
radiotherapy (RT) represent a clinically vulnerable group during the
COVID-19 pandemic. However, systematic data on their clinical course,
comorbidities, and vaccination status are limited. The German National
Pandemic Cohort Network (NAPKON), established to systematically collect
comprehensive clinical data on COVID-19 patients nationwide, provides a
unique opportunity to address this gap. This study aimed to describe
radiation therapy patterns and COVID-19-related clinical characteristics
among patients documented within the NAPKON Cross-Sectoral Platform
(SUEP). Methods: This multicenter, descriptive analysis was
conducted within the framework of the German National Pandemic Cohort
Network (NAPKON). All patients with documented RT and confirmed
SARS-CoV-2 infection were identified in the SUEP database. RT was
classified relative to the documented infection date as occurring
before, during, or after infection. Demographic, clinical, laboratory,
imaging, and vaccination data were extracted and analyzed descriptively.
Due to the small sample size, no correlation or multivariable analyses
were performed. Results: A total of n = 90 patients were included
in the analysis. The median age was 65 years (range 22–90), and 56%
were male. Most patients (93%) received one course of RT, most
frequently targeting specific organ systems (54%), while total body
irradiation was performed in 4%. The median radiation dose was 45 Gy
(IQR 30–60). Among 68 patients with evaluable timing information, RT had
been administered before infection in 53 patients (77.9%), during
infection in 3 patients (4.4%), and after infection in 12 patients
(17.6%). At the time of SARS-CoV-2 detection, 76% of patients
experienced a phase without complications, 19% a phase with
complications, and 2% a critical phase. The majority of vaccinated
individuals had received Comirnaty (BioNTech/Pfizer; 80%).
COVID-19-typical findings were identified in 18% of chest X-rays and 27%
of CT scans. Clinical and laboratory characteristics showed no
substantial differences by hospital length of stay. Conclusions:
Patients with documented RT and SARS-CoV-2 infection in the NAPKON
registry predominantly experienced mild or moderate COVID-19 courses and
showed a relatively high vaccination uptake. However, due to the
descriptive study design and the absence of a control group, these
findings should not be interpreted as being attributable to RT itself
but rather as a characterization of this registry cohort. Importantly,
the cohort mainly comprised patients with a history of RT before
SARS-CoV-2 infection, whereas only a small minority received RT during
infection. Although the analysis was descriptive and limited by missing
data, it demonstrates the feasibility and scientific value of
integrating oncologic subcohorts within national pandemic research
networks. Continued longitudinal analyses will be essential to further
characterize outcomes of patients with cancer and RT in future
pandemics.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Cohort ; Radiation Therapy ; Pandemic ; German ; Vaccination ; Cohort Study ; Cancer ; Coronavirus Disease 2019 (covid-19)
ISSN (print) / ISBN
2673-592X
e-ISSN
2673-592X
Zeitschrift
Radiation
Quellenangaben
Band: 6,
Heft: 2,
Artikelnummer: 13
Verlag
MDPI
Begutachtungsstatus
Peer reviewed
Institut(e)
Institute of Radiation Medicine (IRM)