Neuro-oncology management during the COVID-19 pandemic with a focus on WHO grades III and IV gliomas

Author:

Bernhardt Denise123ORCID,Wick Wolfgang4,Weiss Stephanie E5,Sahgal Arjun6,Lo Simon S7,Suh John H8,Chang Eric L9,Foote Matthew10,Perry James11,Meyer Bernhard12,Vajkoczy Peter13,Wen Patrick Y14,Straube Christoph123,Pigorsch Steffi123,Wilkens Jan J1,Combs Stephanie E123

Affiliation:

1. 1Department of Radiation Oncology, Technical University of Munich (TUM), School of Medicine and Klinikum rechts der Isar, Munich, Germany

2. Department of Radiation Sciences (DRS), Institute of Radiation Medicine (IRM), Neuherberg, Germany

3. Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich, Germany

4. Neurology Clinic, University of Heidelberg and German Cancer Research Center, Heidelberg, Germany

5. Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA

6. Department of Radiation Oncology, Sunnybrook Health Science Centre, Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada

7. Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington, USA

8. Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA

9. Department of Radiation Oncology, Keck School of Medicine at University of Southern California, Los Angeles, California, USA

10. Department of Radiation Oncology, Princess Alexandra Hospital, University of Queensland, Woolloongabba, Queensland, Australia

11. Division of Neurology, Department of Medicine. Odette Cancer and Sunnybrook Health Science Centres, University of Toronto, Toronto, Ontario, Canada

12. Department of Neurosurgery, Technical University of Munich (TUM), School of Medicine and Klinikum rechts der Isar,Munich, Germany

13. Department of Neurosurgery, Charité Universitätsmedizin Berlin, Berlin, Germany

14. Center for Neuro-Oncology, Dana-Farber/Brigham and Women’s Cancer Center, Boston, Massachusetts, USA

Abstract

Abstract Background Because of the increased risk in cancer patients of developing complications caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), physicians have to balance the competing risks of the negative impact of the pandemic and the primary tumor disease. In this consensus statement, an international group of experts present mitigation strategies and treatment guidance for patients suffering from high grade gliomas (HGGs) during the coronavirus disease 2019 (COVID-19) pandemic. Methods Sixteen international experts in the treatment of HGG contributed to this consensus-based practice recommendation, including neuro-oncologists, neurosurgeons, radiation oncologists, and a medical physicist. Generally, treatment of neuro-oncological patients cannot be significantly delayed and initiating therapy should not be outweighed by COVID-19. We present detailed interdisciplinary treatment strategies for molecular subgroups in 2 pandemic scenarios, a scale-up phase and a crisis phase. Conclusion This practice recommendation presents a pragmatic framework and consensus-based mitigation strategies for the treatment of HGG patients during the SARS-CoV-2 pandemic.

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Neurology (clinical),Oncology

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