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Premature discontinuation of curative radiation therapy: Insights from head and neck irradiation

Lazarev, Stanislav, Gupta, Vishal, Ghiassi-Nejad, Zahra, Miles, Brett, Scarborough, Bethann, Misiukiewicz, Krzysztof J., Reckson, Batya, Sheu, Ren-Dih +1 more·2018·Advances in Radiation Oncology
DOI 10.1016/j.adro.2017.10.006PMC PMC5856974
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  • Prior studies suggest that upward of 50% of socially vulnerable RT patients may experience treatment interruptions, particularly uninsured patients and Medicaid beneficiaries.

    “prior studies suggest that upward of 50% of socially vulnerable RT patients may experience treatment interruptions, particularly uninsured patients and Medicaid beneficiaries.17, 18, 19”

    From X-CART: a multimodal real-world data pipeline for explainable AI-driven patient navigation in radiation oncology (2026) · cites this paper as [18]

    The Results (Treatment-related characteristics) report RT interruptions in 66% of patients, supporting the ‘upward of 50%’ figure. But these were 58 head-and-neck cancer patients who had already discontinued curative RT prematurely, not socially vulnerable RT patients generally. The Results (Patient demographic and clinical characteristics) list Medicaid enrollment but provide no interruption rate by insurance status and identify no uninsured group. (LLM, conf=0.88)

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  1. [1]Baskar R. Lee K.A. Yeo R. Yeoh K.W. Cancer and radiation therapy: Current advances and future directions Int J Med Sci 9 2012 193 199 22408567 PMC3298009
  2. [2]Chen Y.P. Tsang N.M. Tseng C.K. Lin S.Y. Causes of interruption of radiotherapy in nasopharyngeal carcinoma patients in Taiwan Jpn J Clin Oncol 30 2000 230 234 10857501
  3. [3]Patel U.A. Thakkar K.H. Holloway N. Patient compliance to radiation for advanced head and neck cancer at a tertiary care county hospital Laryngoscope 118 2008 428 432 18043491
  4. [4]Sethi R.A. Stamell E.F. Price L. DeLacure M. Sanfilippo N. Head and neck radiotherapy compliance in an underserved patient population Laryngoscope 120 2010 1336 1341 20564718
  5. [5]Thomas K. Martin T. Gao A. Ahn C. Wilhelm H. Schwartz D.L. Interruptions of head and neck radiotherapy across insured and indigent patient populations J Oncol Pract 13 2017 e319 e328 28267393
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  7. [7]Groome P.A. O'Sullivan B. Mackillop W.J. Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Population-based outcomes study supporting need for intensified treatment schedules Int J Radiat Oncol Biol Phys 64 2006 1002 1012 16414205
  8. [8]Fesinmeyer M.D. Mehta V. Blough D. Tock L. Ramsey S.D. Effect of radiotherapy interruptions on survival in Medicare enrollees with local and regional head-and-neck cancer Int J Radiat Oncol Biol Phys 78 2010 675 681 20133084
  9. [9]Hansen O. Overgaard J. Hansen H.S. Importance of overall treatment time for the outcome of radiotherapy of advanced head and neck carcinoma: Dependency on tumor differentiation Radiother Oncol 43 1997 47 51 9165136
  10. [10]Cox J.D. Stetz J. Pajak T.F. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC) Int J Radiat Oncol Biol Phys 31 1995 1341 1346 7713792
  11. [11]Chen A.M. Chen L.M. Vaughan A. Head and neck cancer among lifelong never-smokers and ever-smokers: Matched-pair analysis of outcomes after radiation therapy Am J Clin Oncol 34 2011 270 275 20622648
  12. [12]Fesinmeyer M.D. Mehta V. Tock L. Blough D. McDermott C. Ramsey S.D. Completion of radiotherapy for local and regional head and neck cancer in Medicare Arch Otolaryngol Head Neck Surg 135 2009 860 867 19770417
  13. [13]Sharma A. Madan R. Kumar R. Compliance to therapy-elderly head and neck carcinoma patients Can Geriatr J 17 2014 83 87 25232366 PMC4164680
  14. [14]Fang C.Y. Heckman C.J. Informational and support needs of patients with head and neck cancer: Current status and emerging issues Cancers Head Neck 1 2016 15 28670482 PMC5488795
  15. [15]Lee J.A. Lee N.K. Yoon W.S. Treatment interruption during radiation therapy: Experience at a single institution in the Republic of Korea Asia Pac J Clin Oncol 13 2017 e481 e488 27488587
  16. [17]National Comprehensive Cancer Network Distress management clinical practice guidelines J Natl Compr Canc Netw 1 2003 344 374 19761069
  17. [18]Schoenfeld G.O. Amdur R.J. Morris C.G. Li J.G. Hinerman R.W. Mendenhall W.M. Patterns of failure and toxicity after intensity-modulated radiotherapy for head and neck cancer Int J Radiat Oncol Biol Phys 71 2008 377 385 18164838
  18. [19]Marur S. Li S. Cmelak A.J. E1308: Phase II trial of induction chemotherapy followed by reduced-dose radiation and weekly cetuximab in patients with HPV-associated resectable squamous cell carcinoma of the oropharynx- ECOG-ACRIN Cancer Research Group J Clin Oncol 35 2017 490 497 28029303 PMC5455313

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Authors
Lazarev, S., Gupta, V., Ghiassi-Nejad, Z., Miles, B., Scarborough, B., Misiukiewicz, K. J., Reckson, B., Sheu, R.-D., & Bakst, R. L.
Venue
Advances in Radiation Oncology
Publisher
Elsevier BV
Published
2018-01
Volume
3
Issue
1
Pages
62-69
ISSN
2452-1094
DOI
10.1016/j.adro.2017.10.006
PMC
PMC5856974
Cited by
41
References
0
Language
en
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