Randomized Trial of Enhanced Versus Standard Navigation to Promote Timely Initiation of Adjuvant Radiotherapy for Head and Neck Cancer

JCO Oncology Practice, Год журнала: 2025, Номер unknown

Опубликована: Янв. 6, 2025

PURPOSE National Comprehensive Cancer Network Guidelines recommend initiating postoperative radiation therapy (PORT) within 6 weeks of surgery for patients with head and neck squamous cell carcinoma (HNSCC), but delays affect 50% patients, disproportionately burden minoritized groups, contribute to worse oncologic outcomes. This trial evaluates the efficacy Navigation Disparities Untimely Radiation thErapy (NDURE), an enhanced navigation-based intervention, relative usual care (UC) patient navigation starting timely PORT. METHODS Adults locally advanced HNSCC planning undergo PORT were randomly assigned 1:1 standard multidisciplinary oncology either NDURE, a multilevel intervention enhance key processes overcome barriers PORT, or UC, which consisted navigation. The primary end point, initiation defined as ≤6 after surgery, was evaluated using generalized linear model binary regression identity link, adjusting random assignment stratification variables (race, predicted location). Secondary points time (TTP) treatment package (TPT; from completion). RESULTS Among 176 eligible NDURE (n = 88) UC 88), 145 (NDURE, n 67; 78) underwent had pathologic indication evaluable point. improved (model-based 74% v 39%; risk difference, 35% [90% CI, 23 48]). increased rate (TTP hazard ratio [HR], 1.82 1.32 2.50]) completion (TPT HR, 1.67 1.22 2.29]) UC. CONCLUSION In this randomized clinical undergoing TTP, TPT.

Язык: Английский

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Disparities in Survival of Head and Neck Cancer in the Hispanic Population: Systematic‐Review and Meta‐analysis

Otolaryngology, Год журнала: 2025, Номер unknown

Опубликована: Янв. 5, 2025

Abstract Objective The Hispanic health paradox (HHP), the observation that people in United States often experience better outcomes than non‐Hispanic despite having worse prognostic factors, has not been evaluated for patients with head and neck squamous cell carcinoma (HNSCC), a malignancy marked racial disparities outcomes. objective of this study is to evaluate HHP within context HNSCC. Data Sources CINAHL, PubMed, Scopus. Review Methods Studies compared survival between HNSCC were included. Meta‐analysis adjusted hazard ratios (aHRs) 95% confidence intervals (CIs) was conducted compare overall (OS) cancer‐specific (CSS) white (HW) (NHW) Results Of 2106 unique abstracts reviewed, 25 studies included systematic review 22 meta‐analysis. Among 657,185 meta‐analysis, 6.9% (95% CI: 5.8%‐8.3%) ethnicity. HW had improved OS relative NHW (aHR = 0.90, 0.86‐0.94) among 17 reporting CSS 0.87, 0.80‐0.94) 4 outcome. Conclusion exhibit HNSCC, supporting Research needed understand underlying mechanisms, which could provide insights into improving all

Язык: Английский

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Assessing barriers to adjuvant therapy among patients with head and neck cancer in Arkansas

Oral Oncology, Год журнала: 2025, Номер 164, С. 107290 - 107290

Опубликована: Апрель 9, 2025

Язык: Английский

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Factors Contributing to Postoperative Radiotherapy Delays in Head and Neck Cancer: A Comprehensive Review

Cureus, Год журнала: 2024, Номер unknown

Опубликована: Авг. 19, 2024

Head and neck cancer encompasses a diverse group of malignancies that pose significant challenges in their management due to heterogeneity clinical behavior treatment response. Postoperative radiotherapy (PORT) is critical component the regimen for head cancer, aimed at reducing local recurrence improving overall survival (OS). However, delays initiation PORT can significantly compromise patient outcomes. This comprehensive review explores factors contributing such delays, categorizing them into patient-related, treatment-related, systemic factors. Patient-related include health status, comorbidities, socioeconomic barriers, psychological issues. Treatment-related involve surgical complications, complexities planning, coordination between radiation oncology teams. Systemic institutional encompass hospital resources, staffing levels, administrative insurance issues, geographic barriers. The also examined impact these on outcomes, highlighting increased risk reduced rates. Strategies mitigate are discussed, including improved preoperative postoperative enhanced multidisciplinary coordination, education, policy changes. Additionally, case studies real-world examples successful interventions presented. Future directions research recommendations outlined, emphasizing need continued efforts ensure timely patients. aims provide analysis inform practice policy, ultimately standard care outcomes treatment.

Язык: Английский

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Head and Neck Cancer Treatment Delays in 2021: Estimating Distributional Effects by Site, Surgery, and p16-positivity

Oral Oncology Reports, Год журнала: 2024, Номер unknown, С. 100682 - 100682

Опубликована: Окт. 1, 2024

Язык: Английский

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