Abstract：
OBJECTIVE: Evaluate the effect of functional status and patient factors on delays in treatment with adjuvant therapy.
METHODS: Retrospective chart review (2020-2022) was conducted at a single tertiary referral center. Data were collected between January 2020 and October 2022, and 63 patients underwent free flap reconstructive surgery of the head and neck due to the presence of cancer and received adjuvant radiation therapy (RT). The main outcomes measured were Area Deprivation Index (ADI), Beale scores, distance to radiation center, functional status, patient demographics, gender, and length from surgery to initiation of RT.
RESULTS: Of the 63 patients who were reviewed, the average age was 65.5 years old and 63.8% were male. The average ADI state score was 5.6 and the national percentile of 77.1. The average Beale score was 3.7. The average distance traveled was 101.1 miles. Thirty-five patients were living independently, 16 were living in assisted living or received home care, and 15 were dependent or lived in a nursing home. Mann-Whitney U analysis revealed a significant association of increasing levels of dependence to delays in treatment compared to on-time treatment (p = 0.002). The odds of treatment delay were increased almost 10-fold for every additional increase in dependency level (OR = 9.87, 95% CI = 1.42-68.83).
CONCLUSIONS: Degree of dependent functional status correlates with delays in postoperative adjuvant RT in patients undergoing free tissue transfer for head and neck cancer. Preoperative risk stratification allows for physicians to address barriers to adjuvant therapy prior to delay.
METHODS: Level 3 Laryngoscope, 2024.
METHODS: Retrospective chart review (2020-2022) was conducted at a single tertiary referral center. Data were collected between January 2020 and October 2022, and 63 patients underwent free flap reconstructive surgery of the head and neck due to the presence of cancer and received adjuvant radiation therapy (RT). The main outcomes measured were Area Deprivation Index (ADI), Beale scores, distance to radiation center, functional status, patient demographics, gender, and length from surgery to initiation of RT.
RESULTS: Of the 63 patients who were reviewed, the average age was 65.5 years old and 63.8% were male. The average ADI state score was 5.6 and the national percentile of 77.1. The average Beale score was 3.7. The average distance traveled was 101.1 miles. Thirty-five patients were living independently, 16 were living in assisted living or received home care, and 15 were dependent or lived in a nursing home. Mann-Whitney U analysis revealed a significant association of increasing levels of dependence to delays in treatment compared to on-time treatment (p = 0.002). The odds of treatment delay were increased almost 10-fold for every additional increase in dependency level (OR = 9.87, 95% CI = 1.42-68.83).
CONCLUSIONS: Degree of dependent functional status correlates with delays in postoperative adjuvant RT in patients undergoing free tissue transfer for head and neck cancer. Preoperative risk stratification allows for physicians to address barriers to adjuvant therapy prior to delay.
METHODS: Level 3 Laryngoscope, 2024.
摘要：
目的：评估功能状态和患者因素对辅助治疗延迟的影响。
方法：在单个三级转诊中心进行了回顾性图表审查（2020-2022年）。数据收集于2020年1月至2022年10月之间，63例患者由于癌症的存在而接受了头颈部游离皮瓣重建手术，并接受了辅助放射治疗（RT）。测量的主要结果是面积剥夺指数(ADI)，Beale得分,到辐射中心的距离，功能状态，患者人口统计学，性别,以及从手术到开始RT的长度。
结果：在接受检查的63例患者中，平均年龄65.5岁,男性占63.8%。平均ADI状态评分为5.6，全国百分位数为77.1。Beale的平均得分为3.7。平均行驶距离为101.1英里。35名患者独立生活，16人生活在辅助生活或接受家庭护理，15人依赖或住在疗养院。Mann-WhitneyU分析显示，与按时治疗相比，治疗延迟的依赖性水平显着相关（p=0.002）。依赖性水平每增加一次，治疗延迟的几率增加近10倍（OR=9.87，95％CI=1.42-68.83）。
结论：头颈部癌游离组织转移患者术后辅助放疗延迟与功能状态依赖程度相关。术前风险分层允许医生在延迟之前解决辅助治疗的障碍。
方法：三级喉镜，2024.
方法：在单个三级转诊中心进行了回顾性图表审查（2020-2022年）。数据收集于2020年1月至2022年10月之间，63例患者由于癌症的存在而接受了头颈部游离皮瓣重建手术，并接受了辅助放射治疗（RT）。测量的主要结果是面积剥夺指数(ADI)，Beale得分,到辐射中心的距离，功能状态，患者人口统计学，性别,以及从手术到开始RT的长度。
结果：在接受检查的63例患者中，平均年龄65.5岁,男性占63.8%。平均ADI状态评分为5.6，全国百分位数为77.1。Beale的平均得分为3.7。平均行驶距离为101.1英里。35名患者独立生活，16人生活在辅助生活或接受家庭护理，15人依赖或住在疗养院。Mann-WhitneyU分析显示，与按时治疗相比，治疗延迟的依赖性水平显着相关（p=0.002）。依赖性水平每增加一次，治疗延迟的几率增加近10倍（OR=9.87，95％CI=1.42-68.83）。
结论：头颈部癌游离组织转移患者术后辅助放疗延迟与功能状态依赖程度相关。术前风险分层允许医生在延迟之前解决辅助治疗的障碍。
方法：三级喉镜，2024.
