Association of Treatment at High-Volume Facilities With Survival in Patients Receiving Chemoradiotherapy for Nasopharyngeal Cancer | Head and Neck Cancer | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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Research Letter
January 2018

Association of Treatment at High-Volume Facilities With Survival in Patients Receiving Chemoradiotherapy for Nasopharyngeal Cancer

Author Affiliations
  • 1Department of Radiation Oncology, University of Nebraska Medical Center, Omaha
  • 2Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston
  • 3Department of Radiation Oncology, University of Maryland Medical Center, Baltimore
  • 4Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri
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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