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Verma V, Allen PK, Simone CB, Gay HA, Lin SH. Association of Treatment at High-Volume Facilities With Survival in Patients Receiving Chemoradiotherapy for Nasopharyngeal Cancer. JAMA Otolaryngol Head Neck Surg. 2018;144(1):86–89. doi:10.1001/jamaoto.2017.1874
Similar to other head and neck cancers, successful delivery of radiation therapy (RT) in nasopharyngeal cancer (NPC) is challenging. Reasons include technical aspects, such as treatment planning (especially in the era of intensity-modulated RT and simultaneous integrated boosting), physician experience in target delineation (eg, knowing routes of subclinical nodal spread), available technologies (eg, image-guided RT), coordination of multimodality therapy, and treatment of acute and late toxic effects.
Thus, there may be advantages to administering chemoradiotherapy (CRT) at high-volume facilities (HVFs). For similar reasons as the aforementioned, treatment at HVFs and/or from more experienced clinicians have been associated with improved outcomes in the surgical literature.1 Analogously, we hypothesized that treatment at an HVF could improve outcomes in a nonsurgical disease such as NPC, which we evaluated in this study. The National Cancer Database (NCDB) provides a unique resource with which to address this novel and clinically important issue and has been proven to be of great utility for similar studies in other tumor types.2,3
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