Delays Starting Postoperative Radiotherapy Among Head and Neck Cancer Patients: A Systematic Review and Meta-analysis.
Delays Starting Postoperative Radiotherapy Among Head and Neck Cancer Patients: A Systematic Review and Meta-analysis.
复制标题
头颈癌患者延迟开始术后放疗：系统评价和荟萃分析。
DOI：
10.1002/ohn.538
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Nuss
中科院分区：
文献类型：
--
作者：
Duckett,KelseyA;Kassir,MohamedFaisal;Nguyen,ShaunA;Brennan,EmilyA;Chera,BhishamjitS;Sterba,KatherineR;HughesHalbert,Chanita;Hill,ElizabethG;McCay,Jessica;Puram,SidharthV;Sandulache,VladC;Kahmke,Russel;Ramadan,Salma;Nuss
ObjectiveInitiating postoperative radiotherapy (PORT) within 6 weeks (42 days) of surgery is the first and only Commission on Cancer (CoC) approved quality metric for head and neck squamous cell carcinoma (HNSCC). No study has systematically reviewed nor synthesized the literature to establish national benchmarks for delays in starting PORT.Data SourcesFollowing Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines, we performed a systematic review of PubMed, Scopus, and CINAHL.Review MethodsStudies that described time‐to‐PORT or PORT delays in patients with HNSCC treated in the United States after 2003 were included. Meta‐analysis of proportions and continuous measures was performed on nonoverlapping datasets to examine the pooled frequency of PORT delays and time‐to‐PORT.ResultsThirty‐six studies were included in the systematic review and 14 in the meta‐analysis. Most studies utilized single‐institution (n = 17; 47.2%) or cancer registry (n = 16; 44.4%) data. Twenty‐five studies (69.4%) defined PORT delay as >6 weeks after surgery (the definition utilized by the CoC and National Comprehensive Cancer Network Guidelines), whereas 4 (11.1%) defined PORT delay as a time interval other than >6 weeks, and 7 (19.4%) characterized time‐to‐PORT without defining delay. Meta‐analysis revealed that 48.6% (95% confidence interval [CI], 41.4‐55.9) of patients started PORT > 6 weeks after surgery. Median and mean time‐to‐PORT were 45.8 (95% CI, 42.4‐51.4 days) and 47.4 days (95% CI, 43.4‐51.4 days), respectively.ConclusionDelays in initiating guideline‐adherent PORT occur in approximately half of patients with HNSCC. These meta‐analytic data can be used to set national benchmarks and assess progress in reducing delays.
