Urgent considerations for the neuro-oncologic treatment of patients with gliomas during the COVID-19 pandemic

Author:

Mohile Nimish A1,Blakeley Jaishri O2,Gatson Na Tosha N3,Hottinger Andreas F4,Lassman Andrew B5,Ney Douglas E6,Olar Adriana7,Schiff David8,Shih Helen A9,Strowd Roy10,van den Bent Martin J11,Ziu Mateo12ORCID

Affiliation:

1. Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA

2. Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA

3. Geisinger Health, Neuroscience and Cancer Institutes, and Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA

4. Vaud University Hospital Center, Lausanne University Hospital and University of Lausanne, Departments of Clinical Neurosciences and Oncology, Lausanne, Switzerland

5. Department of Neurology and Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center and NY Presbyterian Hospital, New York, New York, USA

6. Departments of Neurology and Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA

7. Departments of Pathology and Neurosurgery, Medical University of South Carolina and Hollings Cancer Center, Charleston, South Carolina, USA

8. University of Virginia, Departments of Neurology, Neurological Surgery, and Medicine, Charlottesville, Virginia, USA

9. Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA

10. Wake Forest School of Medicine, Department of Neurology, Internal Medicine, Section on Hematology and Oncology, Winston-Salem, North Carolina, USA

11. Brain Tumor Center at Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands

12. Department of Neurosurgery, Inova Neuroscience and Spine Institute, Virginia Commonwealth University, Richmond, Virginia, USA

Abstract

Abstract The COVID-19 outbreak is posing unprecedented risks and challenges for all communities and health care systems, worldwide. There are unique considerations for many adult patients with gliomas who are vulnerable to the novel coronavirus due to older age and immunosuppression. As patients with terminal illnesses, they present ethical challenges for centers that may need to ration access to ventilator care due to insufficient critical care capacity. It is urgent for the neuro-oncology community to develop a proactive and coordinated approach to the care of adults with gliomas in order to provide them with the best possible oncologic care while also reducing their risk of viral infection during times of potential health care system failure. In this article, we present an approach developed by an international multidisciplinary group to optimize the care of adults with gliomas during this pandemic. We recommend measures to promote strict physical distancing and minimize exposures for patients, address risk and benefit of all therapeutic interventions, proactively develop end-of-life plans, educate patients and caregivers, and ensure the health of the multidisciplinary neuro-oncology workforce. This pandemic is already changing neuro-oncologic care delivery around the globe. It is important to highlight opportunities to maximize the benefit and minimize the risk of glioma management during this pandemic and potentially, in the future.

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Neurology (clinical),Oncology

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