• Victor Ho-Fun Lee, Marlinda Adham, Wala Ben Kridis, Paolo Bossi, Ming-Yuan Chen, Imjai Chitapanarux, Vincent Gregoire, Sheng Po Hao, Cheryl Ho, Gwo Fuang Ho, Danita Kannarunimit, Dora Lai-Wan Kwong, Ka-On Lam, Wai Kei Jacky Lam, Quynh-Thu Le, Anne Wing-Mui Lee, Nancy Y Lee, To-Wai Leung, Lisa Licitra, Darren Wan-Teck Lim, Jin-Ching Lin, Kwok Seng Loh, Pei-Jen Lou, Jean-Pascal Machiels, Hai-Qiang Mai, Ricard Mesía, Wai-Tong Ng, Roger Kai-Cheong Ngan, Joshua K Tay, Raymond King-Yin Tsang, Chi-Chung Tong, Hung-Ming Wang, and Joseph T Wee.
• Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China. Electronic address: vhflee@hku.hk.
• Lancet Oncol. 2022 Dec 1; 23 (12): e544e551e544-e551.

AbstractThe effects of the COVID-19 pandemic continue to constrain health-care staff and resources worldwide, despite the availability of effective vaccines. Aerosol-generating procedures such as endoscopy, a common investigation tool for nasopharyngeal carcinoma, are recognised as a likely cause of SARS-CoV-2 spread in hospitals. Plasma Epstein-Barr virus (EBV) DNA is considered the most accurate biomarker for the routine management of nasopharyngeal carcinoma. A consensus statement on whether plasma EBV DNA can minimise the need for or replace aerosol-generating procedures, imaging methods, and face-to-face consultations in managing nasopharyngeal carcinoma is urgently needed amid the current pandemic and potentially for future highly contagious airborne diseases or natural disasters. We completed a modified Delphi consensus process of three rounds with 33 international experts in otorhinolaryngology or head and neck surgery, radiation oncology, medical oncology, and clinical oncology with vast experience in managing nasopharyngeal carcinoma, representing 51 international professional societies and national clinical trial groups. These consensus recommendations aim to enhance consistency in clinical practice, reduce ambiguity in delivering care, and offer advice for clinicians worldwide who work in endemic and non-endemic regions of nasopharyngeal carcinoma, in the context of COVID-19 and other airborne pandemics, and in future unexpected settings of severe resource constraints and insufficiency of personal protective equipment.Copyright © 2022 Elsevier Ltd. All rights reserved.

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