The data on the impact the COVID-19 infection on cancer patients is still very limited. A first report on few cancer patients suggests that patients with cancer, but also cancer survivors, have a higher risk of severe COVID-19 events 

Many of our patients are above 60 years of age, receive or have received chemotherapy and do travel to hospitals , something that ranks them among vulnerable groups. Data on brain tumor patients are not available yet , this requires us to take decisions on a patient-by-patient

A few recommendations and considerations from the  «Hellenic Neurooncology Group» (HeNOG) according to the guidelines of the “European Association Neuro-Oncology” (EANO) :

• Recommend high levels of carefulness to our patients (hygiene, social distance)

• Develop teleconsultation for patients, lab tests at outside hospital facilities if face to face contact can be safely avoided

• Consider stretching control MRI appointments in asymptomatic, long-term survivors of less malignant brain tumors, e.g., meningiomas, schwannomas.

• Consider hypofractionated radiotherapy schedules,thus limiting the number of visits to the hospital for patients’ tumors in which this is likely to be feasible without affecting outcome

• Consider to postpone treatment if this is considered safe and feasible, e.g. probable or proven WHO grade II IDH mutant glioma

• Reconsider the risk benefit ratio of chemotherapy, e.g. in MGMT promoter unmethylated glioblastoma, notably in the elderly

• Be more strict in who you operate, postpone is safely possible, avoid if clinical benefit is less likely or marginal