Effects of NDURE on Timely Adjuvant Radiotherapy in HNSCC: Subgroup Analysis of an RCT
In brief
Navigation program raises on-time radiation by up to 46% in head-neck cancer
In a single-center RCT of 145 surgically treated head-and-neck cancer patients, the NDURE navigation intervention increased the proportion receiving postoperative radiation within six weeks by 32% to 46% across age, race, marital status and disease severity subgroups. The broad benefit suggests a practical way to reduce treatment delays and related disparities, though larger multicenter trials are needed to confirm generalizability.
- Journal
- The Laryngoscope (Q1)
- Published
- 6 August 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Jonathan M Hughes, Emily Kistner-Griffin, Reid DeMass, Bhisham S Chera, Katherine R Sterba, Elizabeth G Hill, et al.
- PMID
- 42563232
- DOI
- 10.1002/lary.70791
Why clinicians should know about it
- Picked for Otorhinolaryngology (paper of the day, 8 August 2026): NDURE improves timely adjuvant radiotherapy in HNSCC
Abstract
OBJECTIVE: Delays in initiating postoperative radiation therapy (PORT) are common, disproportionately burden medically underserved populations, and contribute to worse oncologic outcomes. NDURE is an enhanced navigation-based intervention that improved initiation of timely PORT relative to usual care (UC) within a randomized clinical trial (RCT). This study evaluates the effect of NDURE on timely PORT across demographic and clinical subgroups. METHODS: In this exploratory, post hoc subgroup analysis from a single-center RCT, adults with locally advanced HNSCC undergoing surgery and PORT were randomized 1:1 to NDURE or UC. The primary outcome was initiation of timely PORT (≤ 6 weeks of surgery). The effect of NDURE relative to UC was assessed across demographic and clinical subgroups, modeling the primary outcome using a generalized linear model. RESULTS: Among 145 evaluable patients (NDURE, n = 67; UC, n = 78), NDURE improved timely PORT relative to UC across nearly all demographic subgroups, including age ≥ 65 years (RD = 43%, 95% CI, 19% to 64%), Black race (RD = 46%, 95% CI, 10% to 73%), and non-partnered status (RD = 32%, 95% CI, 8% to 53%). NDURE improved timely PORT relative to UC across nearly all clinical subgroups including AJCC stage IV (RD = 39%, 95% CI, 21% to 55%), free flap reconstruction (RD = 40%, 95% CI, 21% to 56%), and patients experiencing a postoperative complication (RD = 39%, 95% CI, 14% to 61%). CONCLUSIONS: NDURE is a broadly effective strategy to improve delivery of timely PORT with potential to attenuate disparities for those at greatest risk. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04030130.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.