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. 2025 Jul;47(7):1807-1815.
doi: 10.1002/hed.28092. Epub 2025 Jan 31.

Impact of Postoperative Radiation Therapy Delay and Treatment Facility Location on Survival in Head and Neck Cancer Patients

Niketna Vivek  1 , Rahul Sharma  2 , Kavita Prasad  2 , Kyle Mannion  2 , Robert J Sinard  2 , Alexander Langerman  2 , Eben Rosenthal  2 , Sarah Rohde  2 , Ryan Whitaker  2 , Natalie Lockney  3 , Michael C Topf  2
Affiliations

Impact of Postoperative Radiation Therapy Delay and Treatment Facility Location on Survival in Head and Neck Cancer Patients

Niketna Vivek et al. Head Neck. 2025 Jul.

Abstract

Background: Time from surgery to initiation of postoperative radiation therapy (PORT) of less than 6 weeks was recently instituted as the first quality metric within head and neck cancer care.

Methods: We performed a retrospective single institution cohort study to investigate predictors of PORT delay and the impact of PORT delay on survival.

Results: PORT delay rate was 73.2%, with a median time to treatment initiation of 51 days. Outside radiation facility treatment was independently associated with increased likelihood of PORT delay (OR 1.94, 95% CI 1.03-3.74, p = 0.043). PORT delay and location of radiation treatment did not impact OS or PFS.

Conclusions: In this single institution study, most patients experienced PORT delay. Patients that were treated at outside radiation facilities were more likely to experience delay. However, PORT delay did not result in statistically significant difference in OS and PFS which contrasts with the current literature.

Keywords: OS; PFS; PORT; TPT; head and neck cancer; postoperative radiation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Clinical timeline—median delay per phase of case. Clinical timeline intervals for patients treated at VUMC (reference facility) versus outside facility: Diagnosis‐to‐surgery, surgery to radiation oncology referral, radiation oncology referral to radiation initiation.
FIGURE 2
FIGURE 2
Kaplan–Meier curve illustrating the difference in overall survival by delay status. A log‐rank statistic is depicted. Median survival was not reached within 2 years.
FIGURE 3
FIGURE 3
Kaplan–Meier curve illustrating the difference in Overall Survival by treatment package time (TPT). A log‐rank statistic is depicted.
See this image and copyright information in PMC

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