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

Publication ,  Journal Article
Thomson, DJ; Palma, D; Guckenberger, M; Balermpas, P; Beitler, JJ; Blanchard, P; Brizel, D; Budach, W; Caudell, J; Corry, J; Corvo, R; Le, Q-T ...
Published in: Radiother Oncol
October 2020

PURPOSE: 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 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 MATERIALS: A 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. RESULTS: In 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. CONCLUSIONS: This 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.

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Published In

Radiother Oncol

DOI

EISSN

1879-0887

Publication Date

October 2020

Volume

151

Start / End Page

314 / 321

Location

Ireland

Related Subject Headings

  • Oncology & Carcinogenesis
  • 5105 Medical and biological physics
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
  • 1112 Oncology and Carcinogenesis
  • 0299 Other Physical Sciences
 

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ICMJE
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Thomson, D. J., Palma, D., Guckenberger, M., Balermpas, P., Beitler, J. J., Blanchard, P., … Yom, S. S. (2020). Practice recommendations for risk-adapted head and neck cancer radiotherapy during the COVID-19 pandemic: An ASTRO-ESTRO consensus statement. Radiother Oncol, 151, 314–321. https://doi.org/10.1016/j.radonc.2020.04.019
Thomson, David J., David Palma, Matthias Guckenberger, Panagiotis Balermpas, Jonathan J. Beitler, Pierre Blanchard, David Brizel, et al. “Practice recommendations for risk-adapted head and neck cancer radiotherapy during the COVID-19 pandemic: An ASTRO-ESTRO consensus statement.Radiother Oncol 151 (October 2020): 314–21. https://doi.org/10.1016/j.radonc.2020.04.019.
Thomson DJ, Palma D, Guckenberger M, Balermpas P, Beitler JJ, Blanchard P, et al. Practice recommendations for risk-adapted head and neck cancer radiotherapy during the COVID-19 pandemic: An ASTRO-ESTRO consensus statement. Radiother Oncol. 2020 Oct;151:314–21.
Thomson, David J., et al. “Practice recommendations for risk-adapted head and neck cancer radiotherapy during the COVID-19 pandemic: An ASTRO-ESTRO consensus statement.Radiother Oncol, vol. 151, Oct. 2020, pp. 314–21. Pubmed, doi:10.1016/j.radonc.2020.04.019.
Thomson DJ, Palma D, Guckenberger M, Balermpas P, Beitler JJ, Blanchard P, Brizel D, Budach W, Caudell J, Corry J, Corvo R, Evans M, Garden AS, Giralt J, Gregoire V, Harari PM, Harrington K, Hitchcock YJ, Johansen J, Kaanders J, Koyfman S, Langendijk JA, Le Q-T, Lee N, Margalit D, Mierzwa M, Porceddu S, Soong YL, Sun Y, Thariat J, Waldron J, Yom SS. Practice recommendations for risk-adapted head and neck cancer radiotherapy during the COVID-19 pandemic: An ASTRO-ESTRO consensus statement. Radiother Oncol. 2020 Oct;151:314–321.
Journal cover image

Published In

Radiother Oncol

DOI

EISSN

1879-0887

Publication Date

October 2020

Volume

151

Start / End Page

314 / 321

Location

Ireland

Related Subject Headings

  • Oncology & Carcinogenesis
  • 5105 Medical and biological physics
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
  • 1112 Oncology and Carcinogenesis
  • 0299 Other Physical Sciences