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REVIEW ARTICLE
Year : 2020  |  Volume : 3  |  Issue : 5  |  Page : 49-53

Coronavirus disease 2019 pandemic and its implications on triaging patients with brain tumors for surgery, radiotherapy, and chemotherapy


1 Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
2 Department of Radiation Oncology (Neuro-Oncology Disease Management Group), Tata Memorial Centre, Mumbai, Maharashtra, India
3 Department of Medical Oncology (Neuro-Oncology Disease Management Group), Tata Memorial Centre, Mumbai, Maharashtra, India

Correspondence Address:
Rakesh Jalali
Apollo Proton Cancer Centre, 100 Feet Road, Taramani, Chennai - 600 041, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CRST.CRST_115_20

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The coronavirus disease 2019 pandemic has the potential to overwhelm the current health-care system in our country. The oncologists face a tricky question as to whom to prioritize treatment for. Postponing cancer treatments might be associated with some risk of compromised clinical outcomes. The risks need to be considered in light of the magnitude of potential benefits, the impact of delaying standard treatment on outcomes, and competing patient-centric and infrastructure priorities. Treatment decisions during the pandemic have to be triaged and prioritized based on the existing health-care facility and the fluidity of the situation. High-priority and urgent interventions include management of suspected high-grade glioma, primary central nervous system lymphoma, and round cell tumors. Low-priority interventions include management of low-grade glioma, benign tumors, and relapsed-refractory brain tumors. Similar to other cancers, the management of patients with brain tumors also needs to be adapted and prioritized; pragmatic patient treatment pathways need to be formalized without compromising the clinical outcomes and overburdening the health infrastructure. Health-care professionals dedicated to oversee the management of patients with brain tumors may have to triage referrals and modify the management of various brain tumors, as treatment pathways will differ from region to region and country to country based on the ground level situation. This document is an endeavor to provide a basic framework to triage and prioritize brain tumor patient management pathways. As the situation is rapidly evolving, we suggest a basic treatment guideline for these patients, which is simple to adopt.


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