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Invited Commentary
December 2018

Timely Adjuvant Postoperative Radiotherapy: Racing to a PORT in the Storm

Author Affiliations
  • 1Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
  • 2Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
JAMA Otolaryngol Head Neck Surg. 2018;144(12):1114-1115. doi:10.1001/jamaoto.2018.2266

Despite the best efforts of multidisciplinary teams treating head and neck cancer, our report cards for patients with head and neck cancer completing treatment within the optimal package time window are poor, earning at most a D+ but perhaps even an F. Delays result from a multifactorial and chaotic storm of issues, including systematic inefficiencies, social obstacles, and medical or surgical complications. In 2 recent National Cancer Database studies of more than 40 000 and more than 15 000 patients, respectively, only 44.7% initiated postoperative radiotherapy (PORT) within the National Comprehensive Cancer Network (NCCN) guideline-directed window of 6 weeks after surgery,1 and only 16.7% had a composite treatment package time of no longer than 83 days, which was the minimum threshold before mortality began to rise.2

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