• Daniela Alterio, Stefania Volpe, Almalina Bacigalupo, Pierluigi Bonomo, Francesca De Felice, Francesco Dionisi, Ida D'Onofrio, Elisa D'Angelo, Alessia Di Rito, Giuseppe Fanetti, Pierfrancesco Franco, Marta Maddalo, Anna Merlotti, Francesco Micciché, Ester Orlandi, Fabiola Paiar, Stefano Ursino, Matteo Pepa, Renzo Corvò, Nadia Gisella Di Muzio, Stefano Maria Magrini, Elvio Russi, Giuseppe Sanguineti, Barbara Alicja Jereczek-Fossa, Vittorio Donato, and Daniela Musio.
• Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
• Med. Oncol. 2020 Aug 17; 37 (10): 85.

AbstractManagement of patients with head and neck cancers (HNCs) is challenging for the Radiation Oncologist, especially in the COVID-19 era. The Italian Society of Radiotherapy and Clinical Oncology (AIRO) identified the need of practice recommendations on logistic issues, treatment delivery and healthcare personnel's protection in a time of limited resources. A panel of 15 national experts on HNCs completed a modified Delphi process. A five-point Likert scale was used; the chosen cut-offs for strong agreement and agreement were 75% and 66%, respectively. Items were organized into two sections: (1) general recommendations (10 items) and (2) special recommendations (45 items), detailing a set of procedures to be applied to all specific phases of the Radiation Oncology workflow. The distribution of facilities across the country was as follows: 47% Northern, 33% Central and 20% Southern regions. There was agreement or strong agreement across the majority (93%) of proposed items including treatment strategies, use of personal protection devices, set-up modifications and follow-up re-scheduling. Guaranteeing treatment delivery for HNC patients is well-recognized in Radiation Oncology. Our recommendations provide a flexible tool for management both in the pandemic and post-pandemic phase of the COVID-19 outbreak.

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