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Effects of NDURE on Timely Adjuvant Radiotherapy in HNSCC: Subgroup Analysis of an RCT
Jonathan M Hughes1, Emily Kistner-Griffin2,3, Reid DeMass2,3
1Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
The Laryngoscope
|August 7, 2026
Summary
The NDURE navigation intervention significantly improved timely postoperative radiation therapy (PORT) initiation for head and neck cancer patients. This enhanced approach benefits diverse patient groups, potentially reducing health disparities.
Area of Science:
- Oncology
- Health Services Research
Background:
- Delays in postoperative radiation therapy (PORT) negatively impact oncologic outcomes.
- These delays disproportionately affect medically underserved populations, exacerbating health disparities.
Purpose of the Study:
- To evaluate the effectiveness of the NDURE enhanced navigation intervention on timely PORT initiation.
- To assess NDURE's impact across various demographic and clinical subgroups in patients with locally advanced head and neck squamous cell carcinoma (HNSCC).
Main Methods:
- A single-center randomized clinical trial (RCT) involving 145 patients with locally advanced HNSCC.
- Patients were randomized to either the NDURE intervention or usual care (UC).
- The primary outcome was the initiation of timely PORT within 6 weeks of surgery, analyzed using a generalized linear model.
Main Results:
- NDURE significantly improved timely PORT initiation compared to UC across most demographic subgroups, including older adults (≥65 years), Black patients, and non-partnered individuals.
- The intervention also demonstrated effectiveness across key clinical subgroups, such as AJCC stage IV, patients undergoing free flap reconstruction, and those experiencing postoperative complications.
Conclusions:
- The NDURE intervention is a broadly effective strategy for improving the delivery of timely PORT.
- NDURE shows potential in mitigating disparities in cancer care for high-risk patient populations.
