TY - JOUR
T1 - Practice Recommendations for Risk-Adapted Head and Neck Cancer Radiation Therapy During the COVID-19 Pandemic:
T2 - An ASTRO-ESTRO Consensus Statement
AU - Thomson, David J.
AU - Palma, David
AU - Guckenberger, Matthias
AU - Balermpas, Panagiotis
AU - Beitler, Jonathan J.
AU - Blanchard, Pierre
AU - Brizel, David
AU - Budach, Wilfred
AU - Caudell, Jimmy
AU - Corry, June
AU - Corvo, Renzo
AU - Evans, Mererid
AU - Garden, Adam S.
AU - Giralt, Jordi
AU - Gregoire, Vincent
AU - Harari, Paul M.
AU - Harrington, Kevin
AU - Hitchcock, Ying J.
AU - Johansen, Jorgen
AU - Kaanders, Johannes
AU - Koyfman, Shlomo
AU - Langendijk, J. A.
AU - Le, Quynh Thu
AU - Lee, Nancy
AU - Margalit, Danielle
AU - Mierzwa, Michelle
AU - Porceddu, Sandro
AU - Soong, Yoke Lim
AU - Sun, Ying
AU - Thariat, Juliette
AU - Waldron, John
AU - Yom, Sue S.
N1 - Publisher Copyright:
© 2020 The Authors
PY - 2020/7/15
Y1 - 2020/7/15
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85083865726&partnerID=8YFLogxK
U2 - 10.1016/j.ijrobp.2020.04.016
DO - 10.1016/j.ijrobp.2020.04.016
M3 - Article
C2 - 32302681
AN - SCOPUS:85083865726
SN - 0360-3016
VL - 107
SP - 618
EP - 627
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 4
ER -
