- Design
- Retrospective single-centre cohort
- Population
- 471 patients with head and neck cancer completing definitive radiotherapy, 2018–2025
- Primary outcome
- Radiotherapy adherence, 3-year recurrence and disease-free survival
- Effect
- Non-adherence OR 0.45 (0.27–0.75); DFS HR 0.61 (0.41–0.91)
This retrospective cohort included 471 patients with head and neck cancer completing curative-intent radiotherapy at one US academic centre between 2018 and 2025. Of these, 148 (31%) attended a multidisciplinary survivorship clinic before radiotherapy ended.
After adjustment for clinical and social factors, attendees had lower odds of radiotherapy non-adherence (OR 0.45, 95% CI 0.27–0.75), a lower three-year recurrence risk (SHR 0.62, 0.40–0.94) and better three-year disease-free survival (HR 0.61, 0.41–0.91).
This is observational: patients who attend an extra clinic during treatment may differ in motivation and support in ways that adjustment cannot capture. But the mechanism is plausible — managing swallowing, nutrition, pain and distress during radiotherapy keeps people on treatment — and those supports cost little to bring forward.
- Consider starting survivorship support — swallowing, nutrition, pain, mood — during radiotherapy rather than after it.
- Flag patients at risk of interrupting radiotherapy early and involve dietetics and speech therapy.
- Treatment gaps in head and neck radiotherapy are worth tracking as a service measure.
- Interpret the survival benefit cautiously; the study shows an association.
Why it matters
It suggests survivorship care may be part of treatment, not only what comes after it.
Don't overread it
Observational and single-centre; attendance was not randomised.
The statistics, in plain English
An odds ratio of 0.45 means less than half the odds of non-adherence. A hazard ratio of 0.61 for disease-free survival means about 39% lower rate of recurrence or death over follow-up — but in a non-randomised comparison, healthier or better-supported patients may simply be more likely to attend.
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