Update on adherence to guidelines for time to initiation of postoperative radiation for head and neck squamous cell carcinoma

被引：16
作者：
Lorenz, F. Jeffrey [1 ]
Mahase, Sean S. S. [1 ,2 ]
Miccio, Joseph [1 ,2 ]
King, Tonya S. S. [3 ]
Pradhan, Sandeep [3 ]
Goyal, Neerav [1 ,3 ,4 ,5 ]
机构：
[1] Penn State Univ, Coll Med, Hershey, PA USA
[2] Penn State Hershey Med Ctr, Dept Radiat Oncol, Hershey, PA USA
[3] Penn State Hershey Med Ctr, Dept Publ Hlth Sci, Hershey, PA USA
[4] Penn State Hershey Med Ctr, Dept Otolaryngol Head & Neck Surg, Hershey, PA USA
[5] Penn State Coll Med, Dept Otolaryngol Head & Neck Surg, 500 Univ Dr MC, Hershey, PA 17033 USA
来源：
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2023年 / 45卷 / 07期
基金：
美国国家卫生研究院;
关键词：
head and neck cancer; head and neck squamous cell carcinoma; postoperative radiation; quality care; treatment delay; THERAPY; RADIOTHERAPY; SURVIVAL; SURGERY;
D O I：
10.1002/hed.27380
中图分类号：
R76 [耳鼻咽喉科学];
学科分类号：
100213 ;
摘要：
BackgroundA prior study reported that over half of patients with HNSCC initiated PORT after 6 weeks from surgery during 2006-2014. In 2022, the CoC released a quality metric for patients to initiate PORT within 6 weeks. This study provides an update on time to PORT in recent years. MethodsThe NCDB and TriNetX Research Network were queried to identify patients with HNSCC who received PORT during 2015-2019 and 2015-2021, respectively. Treatment delay was defined as initiating PORT beyond 6 weeks after surgery. ResultsIn NCDB, PORT was delayed for 62% of patients. Predictors of delay included age >50, female sex, black race, nonprivate insurance/uninsured status, lower education, oral cavity site, negative surgical margins, increased postoperative length of stay, unplanned hospital readmissions, IMRT radiation modality, treatment at an academic hospital or in the Northeast, and surgery and radiation at different facilities. In TriNetX, 64% experienced treatment delay. Additional associations with prolonged time to treatment included never married/divorced/widowed marital status, major surgery (neck dissection/free flaps/laryngectomy), and gastrostomy/tracheostomy dependence. ConclusionsThere continue to be challenges to timely initiation of PORT.
引用
收藏
页码：1676 / 1691
页数：16
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