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Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: An ESTRO-ASTRO consensus statement()
BACKGROUND: The COVID-19 pandemic has caused radiotherapy resource pressures and led to increased risks for lung cancer patients and healthcare staff. An international group of experts in lung cancer radiotherapy established this practice recommendation pertaining to whether and how to adapt radioth...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Author(s). Published by Elsevier B.V.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252074/ https://www.ncbi.nlm.nih.gov/pubmed/32342863 http://dx.doi.org/10.1016/j.radonc.2020.04.001 |
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author | Guckenberger, Matthias Belka, Claus Bezjak, Andrea Bradley, Jeffrey Daly, Megan E. DeRuysscher, Dirk Dziadziuszko, Rafal Faivre-Finn, Corinne Flentje, Michael Gore, Elizabeth Higgins, Kristin A. Iyengar, Puneeth Kavanagh, Brian D Kumar, Sameera Le Pechoux, Cecile Lievens, Yolande Lindberg, Karin McDonald, Fiona Ramella, Sara Rengan, Ramesh Ricardi, Umberto Rimner, Andreas Rodrigues, George B. Schild, Steven E. Senan, Suresh Simone II, Charles B. Slotman, Ben J. Stuschke, Martin Videtic, Greg Widder, Joachim Yom, Sue S. Palma, David |
author_facet | Guckenberger, Matthias Belka, Claus Bezjak, Andrea Bradley, Jeffrey Daly, Megan E. DeRuysscher, Dirk Dziadziuszko, Rafal Faivre-Finn, Corinne Flentje, Michael Gore, Elizabeth Higgins, Kristin A. Iyengar, Puneeth Kavanagh, Brian D Kumar, Sameera Le Pechoux, Cecile Lievens, Yolande Lindberg, Karin McDonald, Fiona Ramella, Sara Rengan, Ramesh Ricardi, Umberto Rimner, Andreas Rodrigues, George B. Schild, Steven E. Senan, Suresh Simone II, Charles B. Slotman, Ben J. Stuschke, Martin Videtic, Greg Widder, Joachim Yom, Sue S. Palma, David |
author_sort | Guckenberger, Matthias |
collection | PubMed |
description | BACKGROUND: The COVID-19 pandemic has caused radiotherapy resource pressures and led to increased risks for lung cancer patients and healthcare staff. An international group of experts in lung cancer radiotherapy established this practice recommendation pertaining to whether and how to adapt radiotherapy for lung cancer in the COVID-19 pandemic. METHODS: For this ESTRO & ASTRO endorsed project, 32 experts in lung cancer radiotherapy contributed to a modified Delphi consensus process. We assessed potential adaptations of radiotherapy in two pandemic scenarios. The first, an early pandemic scenario of risk mitigation, is characterized by an altered risk–benefit ratio of radiotherapy for lung cancer patients due to their increased susceptibility for severe COVID-19 infection, and minimization of patient travelling and exposure of radiotherapy staff. The second, a later pandemic scenario, is characterized by reduced radiotherapy resources requiring patient triage. Six common lung cancer cases were assessed for both scenarios: peripherally located stage I NSCLC, locally advanced NSCLC, postoperative radiotherapy after resection of pN2 NSCLC, thoracic radiotherapy and prophylactic cranial irradiation for limited stage SCLC and palliative thoracic radiotherapy for stage IV NSCLC. RESULTS: In a risk-mitigation pandemic scenario, efforts should be made not to compromise the prognosis of lung cancer patients by departing from guideline-recommended radiotherapy practice. In that same scenario, postponement or interruption of radiotherapy treatment of COVID-19 positive patients is generally recommended to avoid exposure of cancer patients and staff to an increased risk of COVID-19 infection. In a severe pandemic scenario characterized by reduced resources, if patients must be triaged, important factors for triage include potential for cure, relative benefit of radiation, life expectancy, and performance status. Case-specific consensus recommendations regarding multimodality treatment strategies and fractionation of radiotherapy are provided. CONCLUSION: This joint ESTRO-ASTRO practice recommendation established pragmatic and balanced consensus recommendations in common clinical scenarios of radiotherapy for lung cancer in order to address the challenges of the COVID-19 pandemic. |
format | Online Article Text |
id | pubmed-7252074 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The Author(s). Published by Elsevier B.V. |
record_format | MEDLINE/PubMed |
spelling | pubmed-72520742020-05-28 Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: An ESTRO-ASTRO consensus statement() Guckenberger, Matthias Belka, Claus Bezjak, Andrea Bradley, Jeffrey Daly, Megan E. DeRuysscher, Dirk Dziadziuszko, Rafal Faivre-Finn, Corinne Flentje, Michael Gore, Elizabeth Higgins, Kristin A. Iyengar, Puneeth Kavanagh, Brian D Kumar, Sameera Le Pechoux, Cecile Lievens, Yolande Lindberg, Karin McDonald, Fiona Ramella, Sara Rengan, Ramesh Ricardi, Umberto Rimner, Andreas Rodrigues, George B. Schild, Steven E. Senan, Suresh Simone II, Charles B. Slotman, Ben J. Stuschke, Martin Videtic, Greg Widder, Joachim Yom, Sue S. Palma, David Radiother Oncol COVID-19 Rapid Communication BACKGROUND: The COVID-19 pandemic has caused radiotherapy resource pressures and led to increased risks for lung cancer patients and healthcare staff. An international group of experts in lung cancer radiotherapy established this practice recommendation pertaining to whether and how to adapt radiotherapy for lung cancer in the COVID-19 pandemic. METHODS: For this ESTRO & ASTRO endorsed project, 32 experts in lung cancer radiotherapy contributed to a modified Delphi consensus process. We assessed potential adaptations of radiotherapy in two pandemic scenarios. The first, an early pandemic scenario of risk mitigation, is characterized by an altered risk–benefit ratio of radiotherapy for lung cancer patients due to their increased susceptibility for severe COVID-19 infection, and minimization of patient travelling and exposure of radiotherapy staff. The second, a later pandemic scenario, is characterized by reduced radiotherapy resources requiring patient triage. Six common lung cancer cases were assessed for both scenarios: peripherally located stage I NSCLC, locally advanced NSCLC, postoperative radiotherapy after resection of pN2 NSCLC, thoracic radiotherapy and prophylactic cranial irradiation for limited stage SCLC and palliative thoracic radiotherapy for stage IV NSCLC. RESULTS: In a risk-mitigation pandemic scenario, efforts should be made not to compromise the prognosis of lung cancer patients by departing from guideline-recommended radiotherapy practice. In that same scenario, postponement or interruption of radiotherapy treatment of COVID-19 positive patients is generally recommended to avoid exposure of cancer patients and staff to an increased risk of COVID-19 infection. In a severe pandemic scenario characterized by reduced resources, if patients must be triaged, important factors for triage include potential for cure, relative benefit of radiation, life expectancy, and performance status. Case-specific consensus recommendations regarding multimodality treatment strategies and fractionation of radiotherapy are provided. CONCLUSION: This joint ESTRO-ASTRO practice recommendation established pragmatic and balanced consensus recommendations in common clinical scenarios of radiotherapy for lung cancer in order to address the challenges of the COVID-19 pandemic. The Author(s). Published by Elsevier B.V. 2020-05 2020-04-06 /pmc/articles/PMC7252074/ /pubmed/32342863 http://dx.doi.org/10.1016/j.radonc.2020.04.001 Text en © 2020 The Author(s) Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | COVID-19 Rapid Communication Guckenberger, Matthias Belka, Claus Bezjak, Andrea Bradley, Jeffrey Daly, Megan E. DeRuysscher, Dirk Dziadziuszko, Rafal Faivre-Finn, Corinne Flentje, Michael Gore, Elizabeth Higgins, Kristin A. Iyengar, Puneeth Kavanagh, Brian D Kumar, Sameera Le Pechoux, Cecile Lievens, Yolande Lindberg, Karin McDonald, Fiona Ramella, Sara Rengan, Ramesh Ricardi, Umberto Rimner, Andreas Rodrigues, George B. Schild, Steven E. Senan, Suresh Simone II, Charles B. Slotman, Ben J. Stuschke, Martin Videtic, Greg Widder, Joachim Yom, Sue S. Palma, David Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: An ESTRO-ASTRO consensus statement() |
title | Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: An ESTRO-ASTRO consensus statement() |
title_full | Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: An ESTRO-ASTRO consensus statement() |
title_fullStr | Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: An ESTRO-ASTRO consensus statement() |
title_full_unstemmed | Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: An ESTRO-ASTRO consensus statement() |
title_short | Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: An ESTRO-ASTRO consensus statement() |
title_sort | practice recommendations for lung cancer radiotherapy during the covid-19 pandemic: an estro-astro consensus statement() |
topic | COVID-19 Rapid Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252074/ https://www.ncbi.nlm.nih.gov/pubmed/32342863 http://dx.doi.org/10.1016/j.radonc.2020.04.001 |
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