Practice recommendations for risk-adapted head and neck cancer radiotherapy during the COVID-19 pandemic: An ASTRO-ESTRO consensus statement

Abstract

Because 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

A review of the international early recommendations for departments organization and cancer management priorities during the global COVID-19 pandemic: applicability in low- and middle-income countries

“… For ‘COVID-19 and cancer’: Among the 134 articles, 12 were related to either guidelines/recommendations (n = 6) [ [10] , [11] , [12] , [13] , [14] , [15] ] or medical and health system organization (n = 6) [ [16] , [17] , [18] , [19] , [20] , [21] , [22] ]. For the last 3 key words, namely ‘COVID-19 and radiotherapy’ (n = 13) [ [23] , [24] , [25] , [26] , [27] , [28] , [29] ], ‘COVID-19 and guidelines for cancer’ and ‘COVID-19 and recommendations for cancer’, the 21 additional references found were redundant and were found with the first two searches ( Fig. 1 ).…”

Optimization of Patient Management During the COVID-19 Pandemic: Chest CT Scan and PCR as Gatekeepers of the Radiation Therapy Workflow

“…In addition, radiotherapy capacity may even need to be increased as an alternative treatment to compensate for surgery cancellations. While hypofractionated radiotherapy schedules may help to limit the number of hospital visits, daily sessions for at least 2 weeks remain the rule for most curative treatments, with some plans lasting up to 7-8 weeks (12,13). Moreover, strategy relying only on patient selection and prioritizing treatment management alone may not be sufficient in a prolonged healthcare crises (10).…”

Perspectives on how to navigate cancer surgery in the breast, head and neck, skin, and soft tissue tumor in limited-resource countries during COVID-19 pandemic

“… If resources of cancer surgery are strained, radiotherapy or concomitant radiotherapy and chemotherapy could be considered for cancers traditionally treated with primary surgery and all locoregional advanced HNSCC including Oral SCC T2-3N0-2M0, laryngeal SCC T4aN3M0, and sinonasal maxillary SCC T4aN1M0 [ 34 ]. Urgent initiation with radiotherapy (using hypofractionation) for oropharyngeal SCC T2N1-2M0, Laryngeal SCC T3N1M0, oral cavity SCC T2N2M0 with positive margins, and palliative radiotherapy for hypopharyngeal SCC T4N1M1 with obstruction and bleeding [ 34 ] Considering concomitant chemotherapy and radiotherapy, particularly with weekly 30–40 mg/m 2 an cisplatin in outpatient setting Induction of chemotherapy should not be considered to delay the initiation of treatment Surgery for locally and locally advanced HNSCC should not be delayed 2–3 months after initial treatment with radiotherapy and/or with concomitant chemotherapy. More complex surgeries especially those involving plastic reconstruction should be deterred.…”

“…If resources of cancer surgery are strained, radiotherapy or concomitant radiotherapy and chemotherapy could be considered for cancers traditionally treated with primary surgery and all locoregional advanced HNSCC including Oral SCC T2-3N0-2M0, laryngeal SCC T4aN3M0, and sinonasal maxillary SCC T4aN1M0 [ 34 ].…”

“…Urgent initiation with radiotherapy (using hypofractionation) for oropharyngeal SCC T2N1-2M0, Laryngeal SCC T3N1M0, oral cavity SCC T2N2M0 with positive margins, and palliative radiotherapy for hypopharyngeal SCC T4N1M1 with obstruction and bleeding [ 34 ]…”