Head and neck radiotherapy amid the COVID-19 pandemic: practice recommendations of the Italian Association of Radiothera
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ORIGINAL PAPER
Head and neck radiotherapy amid the COVID‑19 pandemic: practice recommendations of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Daniela Alterio1 · Stefania Volpe1,2 · Almalina Bacigalupo3 · Pierluigi Bonomo4 · Francesca De Felice5 · Francesco Dionisi6 · Ida D’Onofrio7 · Elisa D’Angelo8 · Alessia Di Rito9 · Giuseppe Fanetti10 · Pierfrancesco Franco11 · Marta Maddalo12 · Anna Merlotti13 · Francesco Micciché14 · Ester Orlandi15 · Fabiola Paiar16 · Stefano Ursino17 · Matteo Pepa1 · Renzo Corvò3,18 · Nadia Gisella Di Muzio19,20 · Stefano Maria Magrini12 · Elvio Russi13 · Giuseppe Sanguineti21 · Barbara Alicja Jereczek‑Fossa1,2 · Vittorio Donato22,23 · Daniela Musio5,24 Received: 24 June 2020 / Accepted: 5 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Management of patients with head and neck cancers (HNCs) is challenging for the Radiation Oncologist, especially in the COVID-19 era. The Italian Society of Radiotherapy and Clinical Oncology (AIRO) identified the need of practice recommendations on logistic issues, treatment delivery and healthcare personnel’s protection in a time of limited resources. A panel of 15 national experts on HNCs completed a modified Delphi process. A five-point Likert scale was used; the chosen cut-offs for strong agreement and agreement were 75% and 66%, respectively. Items were organized into two sections: (1) general recommendations (10 items) and (2) special recommendations (45 items), detailing a set of procedures to be applied to all specific phases of the Radiation Oncology workflow. The distribution of facilities across the country was as follows: 47% Northern, 33% Central and 20% Southern regions. There was agreement or strong agreement across the majority (93%) of proposed items including treatment strategies, use of personal protection devices, set-up modifications and follow-up re-scheduling. Guaranteeing treatment delivery for HNC patients is well-recognized in Radiation Oncology. Our recommendations provide a flexible tool for management both in the pandemic and post-pandemic phase of the COVID-19 outbreak. Keywords COVID-19 pandemic · Head and neck cancers · Radiation oncology · Clinical practice recommendations
Introduction Management of head and neck cancer (HNC) during the COVID-19 outbreak is challenging [1]. Not only patients diagnosed with HNC are often comorbid and frail [2–4], but may have specific features increasing their risk of being more severely affected by COVID-19 infection [5]. Treatment-related sequelae, including but not limited to Vittorio Donato and Daniela Musio equally contributed to the current work and should be considered as co-last Authors. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12032-020-01409-2) contains supplementary material, which is available to authorized users. * Stefania Volpe [email protected] Extended author information available on the last page of the article
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