Sykes Kevin J, Morrow Emily, Smith Joshua B, Holcomb Andrew J, TenNapel Mindi, Lominska Christopher E, Bur Andrés M, Kakarala Kiran
Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.
Department of Sociology, University of Kansas, Lawrence, Kansas, USA.
Head Neck. 2020 Oct;42(10):2948-2957. doi: 10.1002/hed.26355. Epub 2020 Jul 7.
Delays in postoperative radiotherapy (PORT) for head and neck cancer (HNC) increase the risk for recurrence and mortality. The multifactorial nature of delays calls for an in-depth understanding of potential contributors from the patient's and provider's perspectives. We sought to identify causes of delays in adjuvant radiotherapy initiation for HNC.
We performed a mixed-methods study including patients with HNC care team members. Forty in-depth interviews were performed (26 patients; 14 care team members). Timing and demographic data were collected from medical records.
Median time from surgery to radiotherapy initiation was 45 days; 15 participants began after 42 days. Process delays and failure to communicate the urgency and significance of PORT initiation contributes to delays. Patients with a strong social support system experience less delays.
Achieving reductions in PORT initiation requires efficient care coordination, improved communication between interdisciplinary teams, and strengthening social support systems for patients with HNC.
头颈部癌（HNC）术后放疗（PORT）延迟会增加复发和死亡风险。延迟的多因素性质要求从患者和医疗服务提供者的角度深入了解潜在因素。我们试图确定HNC辅助放疗开始延迟的原因。
我们进行了一项混合方法研究，纳入了HNC护理团队成员和患者。进行了40次深入访谈（26名患者；14名护理团队成员）。从医疗记录中收集时间安排和人口统计学数据。
从手术到放疗开始的中位时间为45天；15名参与者在42天后开始。流程延迟以及未能传达PORT开始的紧迫性和重要性导致了延迟。拥有强大社会支持系统的患者延迟较少。
要减少PORT开始时间，需要高效的护理协调、改善跨学科团队之间的沟通，并加强HNC患者的社会支持系统。
