Delayed Postoperative Radiotherapy in Head & Neck Cancers—A Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
Objectives To evaluate the impact of delayed postoperative radiotherapy (PORT) on overall survival (OS) in patients with head and neck cancers (HNC). Data Sources A systematic review and meta‐analysis were conducted by searching MEDLINE, Embase, CENTRAL, Web of Science, and CINAHL databases. Review Methods Studies assessing the impact of delayed PORT in adult HNC patients were included. A total of 11,171 titles and abstracts were screened, with 52 studies meeting the inclusion criteria. Data were extracted, and a pooled random‐effects analysis was performed. The primary outcome was overall survival (OS), comparing patients receiving timely PORT (within 42 days) to those with delays. Results Of the included studies, 31 were conducted in the United States, with 16 using the National Cancer Database (NCDB). Patients who did not receive PORT within 42 days had a 4% increase in mortality (adjusted Hazard Ratio [aHR]: 1.04 [1.03–1.06]; I 2 = 78%; N = 254,189; 16 studies). Excluding time‐overlapping NCDB‐based studies, the OS benefit for timely treatment persisted (aHR: 1.10 [1.01–1.20]; I 2 = 39%; N = 52,003; 5 studies). Conclusions Initiating PORT within 42 days is significantly associated with decreased mortality in HNC patients, reinforcing CoC recommendations. However, more research is needed to understand the relationship between different time cutoffs and outcomes, and to identify factors contributing to PORT delays. Future studies should explore the impact of treatment delays on patient‐centered outcomes, such as Quality of Life (QoL). Level of Evidence NA Laryngoscope , 135:1563–1570, 2025
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.031 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.018 | 0.036 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".