A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | |
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1 | Site | Subtopic | Eligibility | Trial/Group | Dose/fx | Dose constraints | Notes | Evidence | Link | Link | Link | |||||||||||
2 | Head and neck | Definitive Hypofx | locally advanced | RCR Brazil | 55 Gy/ 20 fx | BED calculations | The ASTRO-ESTRO panel had strong agreement that 2.41-3.0 Gy per fraction was acceptable during late pandemic phases. Concurrent chemo was recommended in mild hypofractionation of ≤2.4 Gy per fraction. | phase II | http://www.ccsenet.org/journal/index.php/cco/article/view/37087 | https://bmccancer.biomedcentral.com/track/pdf/10.1186/s12885-018-4893-5 | https://www.astro.org/ASTRO/media/ASTRO/Daily%20Practice/PDFs/COVID-Thomson-et-al(ROB).pdf | |||||||||||
3 | Head and neck | Post-op Hypofx | locally advanced | RCR Brazil | 50-5 Gy/ 20-22 fx | BED calculations | extrapolation from definitive | http://www.ccsenet.org/journal/index.php/cco/article/view/37087 | https://bmccancer.biomedcentral.com/track/pdf/10.1186/s12885-018-4893-5 | |||||||||||||
4 | Head and neck | Definitive Hypofx | locally advanced | Brazil | 54 Gy/ 18 fx | BED calculations | retrospective | https://www.astro.org/ASTRO/media/ASTRO/Daily%20Practice/PDFs/COVID-Thomson-et-al(ROB).pdf | https://www.ncbi.nlm.nih.gov/pubmed/19475548 | https://www.ncbi.nlm.nih.gov/pubmed/25379320 | ||||||||||||
5 | Head and neck | Definitive Hypofx | oral cavity post op | Korea | 50 Gy/ 20 fx | BED calculations | retrospective | https://www.astro.org/ASTRO/media/ASTRO/Daily%20Practice/PDFs/COVID-Thomson-et-al(ROB).pdf | https://www.e-roj.org/m/journal/view.php?number=1432 | |||||||||||||
6 | Head and neck | Definitive Hypofx | locally advanced | ASTRO-ESTRO guidelines | 62.5-64 Gy/ 25 fx | BED calculations | The ASTRO-ESTRO panel had strong agreement that 2.41-3.0 Gy per fraction was acceptable during late pandemic phases. Concurrent chemo was recommended in mild hypofractionation of ≤2.4 Gy per fraction. | phase II | https://pubmed.ncbi.nlm.nih.gov/29478732/ | https://pubmed.ncbi.nlm.nih.gov/25279959/ | https://www.astro.org/ASTRO/media/ASTRO/Daily%20Practice/PDFs/COVID-Thomson-et-al(ROB).pdf | |||||||||||
7 | Head and neck | Definitive HPV+ | localized HPV+ | NRG HN-002 | 60 Gy/ 30 fx | Conventional | Consider planning first to 70 Gy, then at time of 60 Gy consider end of treatment based on status of patient, clinical response, and viral status in your community. Alternatively, if a patient has tested positive, ending at 60 Gy may be prudent. | phase II | https://www.redjournal.org/article/S0360-3016%2819%2933673-9/fulltext | |||||||||||||
8 | Head and neck | post-op ENE | ENE post-op | MDACC | 60-63 Gy for HPV- 60 Gy for HPV+ | Conventional | 60 Gy may also be appropriate for any extent of ENE in HPV+ based on NRG HN002. In the MDACC dose escalation study, small foci of ENE were allowed in the 60 Gy group. | 1 | https://www.redjournal.org/article/S0360-3016(17)30633-8/abstract | |||||||||||||
9 | Head and neck | Definitive, no chemo | nonchemo, eligible for curative RT | DAHANCA | 66 Gy/ 33 fx, 6 per week | BED calculations | Although not extremely shortened, this regimen does offer an incremental shortening over 35 treatments. | 1 | https://www.ncbi.nlm.nih.gov/pubmed/14511925 | https://www.ncbi.nlm.nih.gov/pubmed/26255764 | ||||||||||||
10 | Head and neck | Definitive, no chemo | nonchemo, eligible for curative RT | RTOG 0022 | 66 Gy/ 30 fx daily | Conventional | Phase II | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846217/pdf/nihms113223.pdf | ||||||||||||||
11 | Head and neck | Definitive, split course | any | Split course Duke Intergroup | 70 Gy, 2 week break at 40 Gy | Conventional | Although proven inferior to conventional fractionation in trials, split course could prove useful in truly emergent situations, such as with a patient who is COVID+, high local prevalence, or severely reduced staffing and resources. Favor continuing treatment per standard fractionation with PPE if feasible in your department. | https://www.nejm.org/doi/full/10.1056/NEJM199806183382503 | https://www.nejm.org/doi/full/10.1056/NEJM199806183382503 | |||||||||||||
12 | Head and neck | Reduced volume | any | ACRIN 6685 Washington U | omit neck in PET -ve and/or pN0 neck omit post-op tonsil bed if no indication to tx | To optimize performance status, especially out of concern that COVID infection could occur at any time, consideration should be given to reduce volume as much as possible. ACRIN showed a 94% NPV in PET negative necks before dissection. Wash U's study showed high LC when RT was omitted to a dissected neck that was pN0. In the AVOID trial, omission of RT to the tonsil post-op bed was safe if there were indications to treat the neck but not the post-op bed. | phase II | https://pubmed.ncbi.nlm.nih.gov/31785337/ | ||||||||||||||
13 | Head and neck | surgery | resectable tumors | - | omission of surgery | If there are already factors present to mandate adjuvant RT, then the patient should proceed to definitive RT or chemo RT and surgery avoided, especially for HPV+ tumors. | ||||||||||||||||
14 | Head and neck | induction chemo | n/a | ASTRO-ESTRO | induction chemo (not recommended) | https://www.astro.org/ASTRO/media/ASTRO/Daily%20Practice/PDFs/COVID-Thomson-et-al(ROB).pdf | ||||||||||||||||
15 | Head and Neck | Hypofx | Glottic T1 | Royal Marsden | 50-52.5 Gy in 15-16 fx | BED calculations | b | Retrospective | https://www.ncbi.nlm.nih.gov/pubmed/12972304 | https://www.ncbi.nlm.nih.gov/pubmed/19375900 | ||||||||||||
16 | Head and Neck | Hypofx | Glottic T2 | Royal Marsden | 55 Gy in 20 fx | BED calculations | 0 | , | https://www.ncbi.nlm.nih.gov/pubmed/16635034 | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4580345/ | ||||||||||||
17 | Skin | Post-op Hypofx | locally advanced | RANZCR | 50-5 Gy/ 20-22 fx | BED calculations | extrapolation from definitive | http://www.ccsenet.org/journal/index.php/cco/article/view/37087 | ||||||||||||||
18 | Skin | HDR | HDR | 20 Gy/ 5 fx daily | ||||||||||||||||||
19 | Skin | Merkel | hypofx | NCCN | 8-24 Gy/1-3 fx | https://www.nccn.org/covid-19/pdf/NCCN-NMSC-Ref2.pdf | https://www.nccn.org/covid-19/pdf/NCCN-NMSC-Ref1.pdf | |||||||||||||||
20 | Skin | SCC, MCca, Rare | SCC, MCca, Rare | RCR | 32.5 Gy/ 4 fx | |||||||||||||||||
21 | Skin | SCC, MCca, Rare | SCC, MCca, Rare | RCR | 40 Gy/ 8 fx | |||||||||||||||||
22 | Skin | SCC, MCca, Rare | SCC, MCca, Rare | RCR | 50 Gy/ 15 fx | BED calculations | ||||||||||||||||
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