1. INTRODUCTION
Since the 20th February 2020, Italy is experiencing one of the most
severe 2019 coronavirus-19 disease (COVID-19) outbreak worldwide, with
the region of Lombardy being the first area in Europe hit by the
pandemic. At present, Lombardy is the most affected areas in Italy, with
15.116 deaths and 82.904 cases as of 12th May 2020. Of
these, 21.632 were diagnosed in the Milan area. Therefore, health care
services across the Region are still facing and unprecedented challenges
in limiting transmission rates in order to guarantee the continuity of
care1.
Cancer patients are often frail and immunocompromised, and therefore at
risk of being more severely affected by COVID-19
infection2,3. Following the Regional resolution
XI-2906 approved on the 8th March 2020, selected
centers were designated as oncological hubs, meaning that they were
called to host patients from hospitals in the frontline for COVID-19
emergency. Since our Institution was included among Lombardy oncological
hubs, a set of procedures were implemented in order to guarantee a safe
care and working environment.
Several reports and recommendations have been published on the
management of head a neck cancer (HNC) from both an ethical and surgical
perspective4–6. Moreover, a recent consensus by the
American and European Societies of Radiation Oncology (ASTRO and ESTRO,
respectively) was published to provide guidelines on optimal radiation
treatment (RT) strategies during the pandemic 7.
Nevertheless, issues related to the management of HNC patients during RT
have not been reported yet. Hence, aim of the current work is to report
on technical aspects and the organization strategies applied in a
Radiation Oncology facility operating in the first European area hit by
the COVID-19 pandemic. As the 4th May represent the end of the lockdown
phase in Italy, we wish to share our experience, and to provide some
highlights on how everyday activities were re-organized to face an
evolving epidemiological scenario, together with the short-term results
of our efforts.