Causes of delays in starting postoperative radiotherapy among head and neck cancer patients

Abstract

To the Editor, Duckett et al deserve admiration for their comprehen-sive meta-analysis and systemic review of the prevalence of postoperative radiotherapy (PORT) delay and assessment of variations among care delivery settings in head and neck cancer (HNC) patients.1 The present systematic review comprised 36 studies, while the meta-analysis covered 14 studies. The meta-analysis revealed that nearly half of patients (48.6%) underwent PORT after a lapse of >6 weeks following surgery. The median and mean surgery-to-PORT (S-PORT) time were 45.8 and 47.4 days, respectively. Despite the well-proven adverse impact of extended S-PORT on patient outcomes, these findings confirm that many HNC patients are not receiving PORT on time. Although it is not feasible to eliminate all factors that prolong S-PORT, we would like to emphasize the significance of two manageable factors that may contribute to the authors' discussion on methods for preventing such delays.