{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T12:56:08Z","timestamp":1791636968715,"version":"4.3.4"},"reference-count":15,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100016058","name":"Townsville Hospital and Health Service","doi-asserted-by":"publisher","award":["THHSSERTA_RCG05_2023"],"award-info":[{"award-number":["THHSSERTA_RCG05_2023"]}],"id":[{"id":"10.13039\/501100016058","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100016058","name":"Townsville Hospital and Health Service","doi-asserted-by":"publisher","award":["THHSSERTA_RPG15_2024"],"award-info":[{"award-number":["THHSSERTA_RPG15_2024"]}],"id":[{"id":"10.13039\/501100016058","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100016058","name":"Townsville Hospital and Health Service","doi-asserted-by":"publisher","award":["THHSSERTA_RPG06_2024"],"award-info":[{"award-number":["THHSSERTA_RPG06_2024"]}],"id":[{"id":"10.13039\/501100016058","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013741","name":"Royal Australian and New Zealand College of Radiologists","doi-asserted-by":"publisher","award":["2024\u2010RANZCR\u2010012"],"award-info":[{"award-number":["2024\u2010RANZCR\u2010012"]}],"id":[{"id":"10.13039\/100013741","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Timely initiation of postoperative radiotherapy (PORT) is critical in head and neck cancer, with delays exceeding 42\u2009days associated with inferior outcomes. However, delays remain common, particularly in regional settings. This study aimed to evaluate targeted quality improvement (QI) interventions on PORT timeliness in a regional Australian tertiary hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010centre QI study was conducted at Townsville University Hospital. Five interventions targeting referrals, multidisciplinary coordination, and radiotherapy workflow were implemented. Serial audits were performed six\u2010monthly for three cycles and compared with pre\u2010intervention. The primary outcome was time from surgery to PORT and the proportion of patients exceeding 42\u2009days. Secondary outcomes included key interval analyses across the treatment pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 78 patients were included (28 pre\u2010intervention and 50 post\u2010intervention). The QI interventions were associated with a 23 percentage\u2010point absolute risk reduction in PORT delay (95% CI 2\u201342;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046). Median time to PORT decreased from 50\u2009days pre\u2010intervention to 42\u2009days. Improvements were driven by reductions in early pathway delays, with surgery to radiation oncology (RO) consultation decreasing from 27 to 20.5\u2009days. Timeliness of RO referrals for externally operated patients also improved (31 to 10\u2009days). However, the interval from RO consult to PORT remained largely unchanged.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This QI project improved early pathway efficiency and reduced extreme delays in PORT. However, the persisting interval between RO consult and PORT likely reflects underlying radiotherapy delivery capacity constraints. Future work should focus on scheduling, resource allocation, and workforce capacity to further improve timeliness to PORT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1754-9485.70188","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T12:44:35Z","timestamp":1791636275000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating Postoperative Radiotherapy Pathways for Head and Neck Cancer Patients in a Regional Hospital in Australia"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5928-9935","authenticated-orcid":false,"given":"Yu\u2010Hsien","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Townsville University Hospital  Townsville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Robards","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Townsville University Hospital  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7441-5129","authenticated-orcid":false,"given":"Joel","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of Oral Health Townsville University Hospital  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3710-7256","authenticated-orcid":false,"given":"Geordie","family":"Meekin","sequence":"additional","affiliation":[{"name":"Department of Oral Health Townsville University Hospital  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9923-2087","authenticated-orcid":false,"given":"James","family":"Nightingale","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Townsville University Hospital  Townsville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Liebenberg","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Townsville University Hospital  Townsville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2969-9283","authenticated-orcid":false,"given":"Pedro","family":"Picco","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Townsville University Hospital  Townsville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivanshan","family":"Pathmanathan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Townsville University Hospital  Townsville Australia"},{"name":"College of Medicine and Dentistry James Cook University  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7971-0069","authenticated-orcid":false,"given":"Timothy","family":"Squire","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Townsville University Hospital  Townsville Queensland Australia"},{"name":"College of Medicine and Dentistry James Cook University  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5064-3408","authenticated-orcid":false,"given":"Tao Daniel","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Townsville University Hospital  Townsville Queensland Australia"},{"name":"College of Medicine and Dentistry James Cook University  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,10]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2025.1665019","article-title":"Global Burden of Head and Neck Cancer: Epidemiological Transitions, Inequities, and Projections to 2050","volume":"15","author":"Sun H.","year":"2025","journal-title":"Frontiers in Oncology"},{"issue":"4","key":"e_1_2_12_3_1","first-page":"77","article-title":"The Multidisciplinary Team (Mdt) in the Treatment of Head and Neck Cancer \u2010 a Single\u2010Institution Experience","volume":"61","author":"Prgomet D.","year":"2022","journal-title":"Acta Clinica Croatica"},{"issue":"7","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1002\/lary.32064","article-title":"The Evolution of Multidisciplinary Head and Neck Cancer Treatment","volume":"135","author":"Contrera K. J.","year":"2025","journal-title":"Laryngoscope"},{"issue":"22","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000003770","article-title":"Identification of High\u2010Risk Subgroups of Patients With Oral Cavity Cancer in Need of Postoperative Adjuvant Radiotherapy or Chemo\u2010Radiotherapy","volume":"95","author":"Chen W. C.","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"24","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"4841","DOI":"10.1002\/cncr.30939","article-title":"Effect of Time to Initiation of Postoperative Radiation Therapy on Survival in Surgically Managed Head and Neck Cancer","volume":"123","author":"Graboyes E. M.","year":"2017","journal-title":"Cancer"},{"issue":"5","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1002\/lary.31990","article-title":"Delayed Postoperative Radiotherapy in Head & Neck Cancers\u2010A Systematic Review and Meta\u2010Analysis","volume":"135","author":"Villemure\u2010Poliquin N.","year":"2025","journal-title":"Laryngoscope"},{"issue":"1","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.prro.2019.09.009","article-title":"Treatment Package Time in Node\u2010Positive Cutaneous Head and Neck Squamous Cell Carcinoma","volume":"10","author":"Daniels C. P.","year":"2020","journal-title":"Practical Radiation Oncology"},{"key":"e_1_2_12_9_1","unstructured":"Skin cancer squamous cell carcinoma adjuvant EBRT post\u2010operative St Leonards: eviQ 2025available from https:\/\/www.eviq.org.au\/radiation\u2010oncology\/skin\/1033\u2010skin\u2010cancer\u2010squamous\u2010cell\u2010carcinoma\u2010adjuvant#history."},{"issue":"6","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1111\/1754-9485.13449","article-title":"Evaluating Delays in Patients Treated With Post\u2010Operative Radiation Therapy for Head and Neck Squamous Cell Carcinoma","volume":"66","author":"Marwah R.","year":"2022","journal-title":"Journal of Medical Imaging and Radiation Oncology"},{"issue":"7","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1002\/hed.28092","article-title":"Impact of Postoperative Radiation Therapy Delay and Treatment Facility Location on Survival in Head and Neck Cancer Patients","volume":"47","author":"Vivek N.","year":"2025","journal-title":"Head & Neck"},{"key":"e_1_2_12_12_1","unstructured":"Townsville Hospital and Health Service Strategy and reports 2026available from https:\/\/www.townsville.health.qld.gov.au\/research\/for\u2010researchers\/strategy\u2010and\u2010reports\/."},{"key":"e_1_2_12_13_1","unstructured":"RO Practice Standards Working Group Radiation Oncology Practice Standards: Part B Guidelines 2022."},{"key":"e_1_2_12_14_1","unstructured":"Radiation Oncology Tripartite Committee Planning for the best: Tripartite National Strategic Plan for Radiation Oncology 2012\u20132022 2012."},{"key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ejmp.2020.12.015","article-title":"Personalized Automation of Treatment Planning in Head\u2010Neck Cancer: A Step Forward for Quality in Radiation Therapy?","volume":"82","author":"Cilla S.","year":"2021","journal-title":"Physica Medica"},{"issue":"1","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s13014-017-0808-x","article-title":"RapidPlan Head and Neck Model: The Objectives and Possible Clinical Benefit","volume":"12","author":"Fogliata A.","year":"2017","journal-title":"Radiation Oncology"}],"container-title":["Journal of Medical Imaging and Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1754-9485.70188","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1754-9485.70188","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1754-9485.70188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T12:44:38Z","timestamp":1791636278000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1754-9485.70188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,10]]},"references-count":15,"alternative-id":["10.1111\/1754-9485.70188"],"URL":"https:\/\/doi.org\/10.1111\/1754-9485.70188","archive":["Portico"],"relation":{},"ISSN":["1754-9477","1754-9485"],"issn-type":[{"value":"1754-9477","type":"print"},{"value":"1754-9485","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,10]]},"assertion":[{"value":"2026-05-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1754-9485.70188"}}