Recommendations on Management of Locally Advanced Rectal Cancer During the COVID-19 Pandemic: an Iranian Consensus

Abstract

Purpose Today, the rapid outbreak of COVID-19 is the leading health issue. Patients with cancer are at high risk for the development of morbidities of COVID-19. Hence, oncology centers need to provide organ-based recommendations for optimal management of cancer in the COVID-19 era. Methods In this article, we have provided the recommendations on management of locally advanced rectal cancer during the COVID-19 pandemic based on our experience in Shohada-e Tajrish Hospital, Iran. Results We recommend that patients with locally advanced rectal cancer should be managed in an individualized manner in combination with local conditions related to COVID-19. Conclusion Our recommendation may provide a guide for oncology centers of developing countries for better management of locally advanced rectal cancer.

Radiotherapy based management during Covid-19 pandemic – A systematic review of presented consensus and guidelines

“…For locally advanced rectal cancer (LARC), delaying radiotherapy is not recommended to decrease the recurrence rate and increase anal sphincter preservation probability ( Siavashpour et al, 2020 ). However, neoadjuvant short-course radiation therapy (SCRT) (i.e., 25 Gy in 5 frs) with postponed surgery (up to three months) for the intermediate- to high-risk patients can be an optimum choice based on the recommendations of the pandemic setting to decrease the frequency and duration of the patients' exposure.…”

COVID-19 safe and fully operational radiotherapy: An AIRO survey depicting the Italian landscape at the dawn of phase 2

“…The reduction of registered daily cases is imputable to the strict safety measures adopted and not to the decrease in number of treated patients. On the contrary, with the advent of P2, RT Directors globally reported a progressive realignment with the pre COVID-19 era workload for both outpatient and clinical activities, with a partial or complete reactivation of the previously interrupted or postponed treatments, also thanks to the several guidelines published to help clinicians coping with the novel pandemic scenario [5][6][7][8][9][10][11][12][13][14][15][16][17]. Therefore, the present survey demonstrated how the planned pro- gressive return to a novel routine during P2 has been attained by most Italian RT centres, maintaining high safety standards against a possible new spread of the infection and registering a lower number of positives cases among both patients and health professionals despite the resumption of a pre COVID-19 era workload.…”

Review on the Oncology Practice in the Midst of COVID-19 Crisis: The Challenges and Solutions

“…To that end, the European Society of Medical Oncology (ESMO) has provided free online accessible protocols on how to maintain cancer care over the viral pandemic. In addition, oncologists have published their own experiences on the management of site-specific malignancies to provide a guide for their colleagues in the pandemic situation (Dietz et al, 2020;Guckenberger et al, 2020;Hanna et al, 2020a;Siavashpour et al, 2020;Thomson et al, 2020;Zaorsky et al, 2020). Also, several oncologists have opted to apply their experiences in the treatment of cancer toward the management of COVID-19; for example, use of low-dose whole-lung radiotherapy in the treatment of COVID-19 pneumonia (Ameri et al, 2020a;Ameri et al, 2020b;Hess et al, 2020).…”