Effect of time to initiation of postoperative radiation therapy on survival in surgically managed head and neck cancer.

摘要: BACKGROUND The objective of this study was to determine the effects National Comprehensive Cancer Network (NCCN) guideline–adherent initiation postoperative radiation therapy (PORT) and different time-to-PORT intervals on overall survival (OS) patients with head neck squamous cell carcinoma (HNSCC). METHODS The Data Base reviewed for period 2006-2014, HNSCC undergoing surgery PORT were identified. Kaplan-Meier estimates, Cox regression analysis, propensity score matching used initiating within 6 weeks survival. RESULTS This included 41,291 patients. After adjustments covariates, starting >6 postoperatively associated decreased OS (adjusted hazard ratio [aHR], 1.13; 99% confidence interval [CI], 1.08-1.19). This finding remained in score–matched subset (hazard ratio, 1.21; CI, 1.15-1.28). In comparison 5 postoperatively, earlier not improved (aHR for ≤ 4 weeks, 0.93; 0.85-1.02; aHR 4-5 0.92; 0.84-1.01). Increasing durations delay beyond 7 small, progressive decrements (aHR, 1.09, 1.10, 1.12 7-8, 8-10, >10 respectively). CONCLUSIONS Nonadherence NCCN guidelines survival. There no benefit recommended 6-week timeframe. decrements. 2017;123:4841-50. © 2017 American Society.