Meeting the challenges imposed by COVID-19: Guidance document by the ESTRO Radiation TherapisT (RTT) Committee - PDF Version 

COVID-19 – a novel, highly contagious corona virus – was first reported in December 2019 and its passage around the world was subsequently recognised by the World Health Organisation as a global pandemic. The virus has been affecting everyone’s life significantly and imposing difficult challenges to general medical care practices, including radiation oncology. Without the availability yet of a proven and developed vaccine to COVID-19, this virus will probably continue to have an impact on our everyday lives in the foreseeable future. 

In response to threats imposed by COVID-19 in radiotherapy, the Radiation TherapisT Committee (RTTC)  of the European SocieTy for Radiotherapy and Oncology (ESTRO) has prepared a guidance document [1] and an infographic [2]. Currently the infographic is available in English, Spanish and Portuguese. Versions of the infographic in different languages are in progress. The documents aim to provide guidance on necessary precautions to be adopted in routine clinical radiotherapy practice. They present the recommendations for four domains: patient care, radiotherapist workflow, remote working and radiotherapy practice. 

Detailed recommendations are discussed in the guidance document on how radiotherapy departments can continue to provide a safe and efficient service to both patients and radiation therapists (RTTs) during the current COVID-19 pandemic. The exploration of new ways to react to further outbreaks is a prerequisite in long-term planning. Ongoing monitoring of the situation is needed within individual health organisations, in partnership with radiation therapists. 

Radiation therapists play a key and non-replaceable role in cancer patients’ radiotherapy pathways. Apart from offering radiotherapy planning and treatment delivery, they provide face-to-face contact and advise patients on all aspects of radiotherapy. Radiation therapists are among frontline healthcare workers who are at risk of exposure to COVID-19, or of transmitting the virus to their patients (especially when the radiation therapist is asymptomatic).  

Radiation therapists must be empowered with appropriate guidance and personal protection equipment in order to provide a safe radiotherapy service by limiting potential viral exposure to patients, healthcare workers and the general public.  

Healthcare resources are limited and there are shortages due to the ongoing or recurrent COVID-19 outbreaks. It is essential that we continue to learn, adapt and support each other within the radiation oncology community, especially when confronted by a virus that we do not yet fully understand. 

We hope everyone can stay safe, so that we can continue to make our patients safe!  

Yat Tsang, Aileen Duffton and Philipp Scherer
On behalf of ESTRO RTTC 


Yat Tsang 


Aileen Duffton 


Philipp Scherer 


  1. Y. Tsang, A. Duffton, M. Leech, M. Rossi, P. Scherer, on behalf of ESTRO RTTC. Meeting the challenges imposed by COVID-19: Guidance document by the ESTRO Radiation TherapisT Committee (RTTC). Technical Innovations & Patient Support in Radiation Oncology (2020). doi: 10.1016/j.tipsro.2020.05.003