Head & Neck Cancer Health Care Delivery Research Nomograms to Predict Treatment Delay

For patients with locoregionally advanced, surgically treated head and neck cancer, National Comprehensive Cancer Network (NCCN) Guidelines recommend starting postoperative radiation therapy (PORT) within 6 weeks of surgery to maximize survival and decrease the risk of recurrence.

Guidelines say radiation therapy should start within six weeks of surgery

Unfortunately, delays in starting PORT after surgical treatment of head and neck cancer affect more than one out of every two head and neck cancer patients.

Unfortunately, over half of head and neck cancer patients experience a delay in starting radiation more than six weeks after surgery

To address the lack of precise tools to predict treatment delays, our Head and Neck Cancer Healthcare Delivery Team has generated two risk-prediction calculators. The first calculator generates personalized estimates of PORT initiation delay and may be used to improve pretreatment counseling and the delivery of interventions to patients at high risk for PORT delay. The second calculator includes postsurgical data to calculate a risk of PORT delay and can be used to drive institutional quality improvement initiatives and enhance risk-adjusted comparisons of PORT delay rates across facilities.

Personalized, Presurgical Calculator to Predict the Risk of Delayed Postoperative Radiation Therapy

This calculator uses information available in the presurgical period to generate patient-specific, personalized estimates of the risk of delayed PORT initiation (i.e. more than 6 weeks after surgery). This personalized risk-estimate may be used by clinicians to enhance pre-treatment counseling with patients about the likelihood of experiencing a delay starting guideline-adherent PORT. These risk estimate derived from this calculator may also be used to guide the implementation of interventions for patients at high-risk for delayed PORT administration.

Calculator to Predict the Risk of Delayed Postoperative Radiation Therapy for Quality Improvement Initiatives and Institutional Risk-Adjustment

This calculator uses information from the pre- and post-surgical periods to generate patient-specific, personalized estimates of the risk of delayed PORT initiation (i.e. more than 6 weeks after surgery). This risk-estimate may be used to drive institutional quality improvement initiatives and enhance risk-adjusted comparisons of PORT delay rates across facilities.

More Information About These Risk Calculators

For more information about the development and validation of these risk calculators, please see:

Levy D, Li H, Sterba KR, Hughes-Halbert C, Warren GW, Nussenbaum B, Alberg AJ, Day TA, Graboyes EM. Development and Validation of Nomograms for Predicting Delayed Postoperative Radiotherapy Initiation in Head and Neck Squamous Cell Carcinoma. JAMA Otolaryngol Head Neck Surg. 2020 April 2; doi:10.1001/jamaoto.2020.0222 [Epub ahead of print]. PMID: 32239201. NIHMSID: 1581763.