Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Cancer. 2020 Sep 15;126(18):4092-4104. doi: 10.1002/cncr.33031. Epub 2020 Jul 8.
Because of the national emergency triggered by the coronavirus disease 2019 (COVID-19) pandemic, government-mandated public health directives have drastically changed not only social norms but also the practice of oncologic medicine. Timely head and neck cancer (HNC) treatment must be prioritized, even during emergencies. Because severe acute respiratory syndrome coronavirus 2 predominantly resides in the sinonasal/oral/oropharyngeal tracts, nonessential mucosal procedures are restricted, and HNCs are being triaged toward nonsurgical treatments when cures are comparable. Consequently, radiation utilization will likely increase during this pandemic. Even in radiation oncology, standard in-person and endoscopic evaluations are being restrained to limit exposure risks and preserve personal protective equipment for other frontline workers. The authors have implemented telemedicine and multidisciplinary conferences to continue to offer standard-of-care HNC treatments during this uniquely challenging time. Because of the lack of feasibility data on telemedicine for HNC, they report their early experience at a high-volume cancer center at the domestic epicenter of the COVID-19 crisis.
由于 2019 冠状病毒病(COVID-19)大流行引发的国家紧急状态,政府强制实施的公共卫生指令不仅极大地改变了社会规范,也改变了肿瘤医学的实践。即使在紧急情况下,也必须优先考虑及时治疗头颈部癌症(HNC)。由于严重急性呼吸综合征冠状病毒 2 主要存在于鼻窦/口腔/口咽道,因此限制了非必要的黏膜手术,并且当治疗效果相同时,HNC 被分诊为非手术治疗。因此,在大流行期间,辐射的使用可能会增加。即使在放射肿瘤学中,标准的面对面和内镜评估也受到限制,以限制暴露风险并为其他一线工作人员保留个人防护设备。作者已经实施了远程医疗和多学科会议,以便在这个极具挑战性的时期继续提供 HNC 的标准治疗。由于缺乏关于 HNC 远程医疗的可行性数据,他们报告了在 COVID-19 危机国内中心的一个大容量癌症中心的早期经验。