How long after surgery would you no longer offer adjuvant postoperative treatment for head and neck cancer when a patient (with multiple adverse features that needs adjuvant treatment) keeps postponing the start of radiation?

Is there a time cutoff where there is no longer a benefit to adjuvant radiation and you recommend reserving radiation only in case of recurrence?

Similar questions have been asked, but they focus on impact of treatment related delays causing total treatment time to exceed 90 - 100 days.

Answer from: Radiation Oncologist at Academic Institution

Ultimately, I feel this depends on why the patient keeps postponing treatment. If there are legitimate medical reasons for delay, I would not have a cutoff for starting adjuvant RT at any time - even several months after surgery - as long as the patient can tolerate curative-intent therapy and I hav...

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Answer from: Radiation Oncologist at Academic Institution

I agree that there’s not line in the sand. I try to start postop RT within 6 weeks and certainly within 8 weeks. My enthusiasm begins to wane after 8 weeks and by 3 months it’s pretty much gone.

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How long after surgery would you no longer offer adjuvant postoperative treatment for head and neck cancer when a patient (with multiple adverse features that needs adjuvant treatment) keeps postponing the start of radiation?

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