Keep calm and carry on: safety, feasibility and early outcomes of head and neck cancer treatment during the COVID-19 pandemic

Background Patients with cancer are considered at higher risk of COVID-19 infection and increased severity of infection. Anti-cancer treatment may further increase those risks. The aim of this work is to report early outcomes in patients with head and neck cancer (HNC) treated during the pandemic. Materials and Methods A retrospective cohort study in a UK tertiary level oncology centre between 1st March and 23 June 2020, including patients with HNC who were either newly diagnosed, had developed new recurrent/metastatic disease, or were already scheduled to receive treatment during that period. Results 200 patients were evaluated. Median age was 64 years, 65.5% had multiple co-morbidities, 77.5% were current or ex-smokers and 59.5% lived in areas of deprivation. 99 patients were treated with 6 weeks of radical (chemo) radiotherapy. Systemic anti-cancer treatment was delivered to 40 patients. 2 (1.0%) patients with HNC had confirmed COVID-19 infection; 1 patient prior to primary radical RT - no delay to treatment was required and RT was completed as planned, 1 patient acquired COVID-19 after primary surgery but recovered well and started adjuvant RT 9.7 weeks after surgery. The proportion of patients receiving supportive care only (19.5%) was in keeping with that pre-COVID-19. The proportion of patients not completing (chemo) radiotherapy (3.4%) or with gaps in treatment (14.1%) was similar to pre-COVID-19. 30-day mortality after radical (chemo)radiotherapy was 2.3%, no higher than in previous years. Conclusions It is feasible and safe to deliver standard treatment for patients with HNC during the COVID-19 pandemic.