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Head and neck cancer radiotherapy amid COVID-19 pandemic: Report from Milan, Italy.

ABSTRACT: BACKGROUND:Management of head and neck cancers (HNC) in radiation oncology in the coronavirus disease 2019 (COVID-19) era is challenging. Aim of our work is to report organization strategies at a radiation therapy (RT) department in the first European area experiencing the COVID-19 pandemic. METHODS:We focused on (a) dedicated procedures for HNC, (b) RT scheduling, and (c) health care professionals' protection applied during the COVID-19 breakdown (from March 1, 2020 to April 30, 2020). RESULTS:Applied procedures are reported and discussed. Forty-three patients were treated. Image-guided, intensity modulated RT was performed in all cases. Median overall treatment time was 50 (interquartile range: 47-54.25) days. RT was interrupted/delayed in seven patients (16%) for suspected COVID-19 infection. Two health professionals managing HNC patients were proven as COVID-19 positive. CONCLUSION:Adequate and well-timed organization allowed for the optimization of HNC patients balancing at the best of our possibilities patients' care and personnel's safety.

SUBMITTER: Alterio D

PROVIDER: S-EPMC7323327 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Head and neck cancer radiotherapy amid COVID-19 pandemic: Report from Milan, Italy.

Alterio Daniela D Volpe Stefania S Marvaso Giulia G Turturici Irene I Ferrari Annamaria A Leonardi Maria Cristina MC Lazzari Roberta R Fiore Massimo Sarra MS Bufi Giammaria G Cattani Federica F Arrobbio Camilla C Patti Filippo F Casbarra Alessia A Cavallo Iacopo I Mastrilli Fabrizio F Orecchia Roberto R Jereczek-Fossa Barbara Alicja BA

Head & neck 20200618 7

<h4>Background</h4>Management of head and neck cancers (HNC) in radiation oncology in the coronavirus disease 2019 (COVID-19) era is challenging. Aim of our work is to report organization strategies at a radiation therapy (RT) department in the first European area experiencing the COVID-19 pandemic.<h4>Methods</h4>We focused on (a) dedicated procedures for HNC, (b) RT scheduling, and (c) health care professionals' protection applied during the COVID-19 breakdown (from March 1, 2020 to April 30, ...[more]

PMID: 32557972

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Project description:PurposeBecause of the unprecedented disruption of health care services caused by the COVID-19 pandemic, the American Society of Radiation Oncology (ASTRO) and the European Society for Radiotherapy and Oncology (ESTRO) identified an urgent need to issue practice recommendations for radiation oncologists treating head and neck cancer (HNC) in a time of limited resources and heightened risk for patients and staff.Methods and materialsA panel of international experts from ASTRO, ESTRO, and select Asia-Pacific countries completed a modified rapid Delphi process. Topics and questions were presented to the group, and subsequent questions were developed from iterative feedback. Each survey was open online for 24 hours, and successive rounds started within 24 hours of the previous round. The chosen cutoffs for strong agreement (≥80%) and agreement (≥66%) were extrapolated from the RAND methodology. Two pandemic scenarios, early (risk mitigation) and late (severely reduced radiation therapy resources), were evaluated. The panel developed treatment recommendations for 5 HNC cases.ResultsIn total, 29 of 31 of those invited (94%) accepted, and after a replacement 30 of 30 completed all 3 surveys (100% response rate). There was agreement or strong agreement across a number of practice areas, including treatment prioritization, whether to delay initiation or interrupt radiation therapy for intercurrent SARS-CoV-2 infection, approaches to treatment (radiation dose-fractionation schedules and use of chemotherapy in each pandemic scenario), management of surgical cases in event of operating room closures, and recommended adjustments to outpatient clinic appointments and supportive care.ConclusionsThis urgent practice recommendation was issued in the knowledge of the very difficult circumstances in which our patients find themselves at present, navigating strained health care systems functioning with limited resources and at heightened risk to their health during the COVID-19 pandemic. The aim of this consensus statement is to ensure high-quality HNC treatments continue, to save lives and for symptomatic benefit.

Dataset Information

Head and neck cancer radiotherapy amid COVID-19 pandemic: Report from Milan, Italy.

Publications

Head and neck cancer radiotherapy amid COVID-19 pandemic: Report from Milan, Italy.

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