Abstract
Introduction: The COVID-19 pandemic is now imposing an immense strain on the oncology health care system, both in terms of optimal cancer care and safe delivery and execution of treatment. The period of lockdown has also created additional concerns over completion of interrupted treatments, progression of disease, the delay and increasing waiting list in the backdrop of limited health care resources and personnel.
In Asian countries, a large bulk of patients present with locally advanced cancers of the head and neck, breast and cervix. However other cancers involving esophagus, lung and brain also impose a problem during the pandemic because of the morbidity and mortality associated with postponed treatment.
Purpose and Objectives: In the midst of the COVID-19 pandemic, priority to minimise the risk of exposure of infection to patients and health care personnel is critical in ensuring the sustenance and completeness of treatment. The authors would like to provide optional hypofractionated protocols supported by scientific data that may be used as an interval expedient during this crisis.
Materials and Methods: A systematic literature research was done using Pubmed and other search engines. The focus was on scientific rationale, clinical adaptability, manageable toxicity and with comparable treatment outcomes with the standards of care.
Conclusions: The authors propose shorter, hypofractionated protocols with the option of selective concurrent chemotherapy in the management of head and neck cancer as well as the potential of shorter treatment options for esophageal and lung cancers and high grade gliomas. A few alternatives for an integrated boost to counter the reduced availability of brachytherapy have also been elaborated on.
Keywords: COVID-19, locally advanced cancers, hypofractionation.
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Corresponding Author
Dr Bindhu Joseph
Associate Professor, Department of Radiation Oncology, Kidwai Memorial Institute of Oncology
DOI: https://dx.doi.org/10.18535/jmscr/v9i2.09
