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Navigation-Based Multilevel Intervention with Treatment as Usual to Improve Initiation of Timely Postoperative Radiation Therapy in Adults with Locally Advanced Head and Neck Cancer, ENDURE Trial

Trial Status: active

This clinical trial tests the Enhanced Navigation for Disparities and Untimely Radiation Therapy (ENDURE) navigation-based, multilevel intervention in combination with usual care to improve initiation of timely postoperative radiation therapy in adults with head and neck cancer that has spread to nearby tissue or lymph nodes (locally advanced). Head and neck cancer is associated with poor survival despite aggressive combinations of surgery, radiation, chemotherapy, and immunotherapy and is a disease with profound racial disparities in mortality; Black patients with head and neck cancer have an approximately 50% relative decrease in survival compared to White patients with head and neck cancer. Initiation of postoperative radiation therapy within 6-weeks of surgery is recommended by the National Comprehensive Cancer Network Guidelines and is the first and only Commission on Cancer approved quality metric for head and neck cancer. Delays starting radiation therapy are associated with a decrease in 5-year survival and increased risk of mortality. Unfortunately, delays starting radiation therapy affect approximately 50% of patients with head and neck cancer and nearly 70% of Black patients and are thus a key modifiable driver of poor survival and racial disparities in mortality. Information gained from this trial may allow researchers to determine whether an enhanced patient navigation-based intervention can improve initiation and decrease racial disparities in starting timely, guideline adherent radiation therapy following surgery for locally advanced head and neck cancer.