(126) Sociodemographic Factors Associated With Receipt of Guideline-Concordant Adjuvant Radiation Therapy in Parotid Gland Malignancies

Introduction: This study evaluates sociodemographic factors associated with receiving guideline-concordant adjuvant radiation in patients with high-risk parotid malignancies.

Methods: Patients with primary malignant parotid gland tumors were identified from the SEER 17 database (2004–2022). Inclusion was limited to patients who underwent surgical resection and met guideline-based indications for adjuvant radiation therapy, defined by high-risk clinicopathologic features including advanced tumor stage (AJCC T3–T4), regional nodal involvement (N+ disease), and high-grade histological features. The primary outcome was receipt of adjuvant radiation among guideline-eligible patients. Multivariable logistic regression evaluated associations between sociodemographic factors and receipt of guideline-concordant adjuvant radiation, reported as adjusted odds ratios (ORs) with 95% confidence intervals (CIs).

Results: After multivariable adjustment, older age was independently associated with lower odds of receiving guideline-concordant adjuvant radiation (OR 0.987 per year, 95% CI 0.975–0.998, p = 0.023). Divorced and separated patients demonstrated higher odds of receiving adjuvant radiation compared to single patients (OR 3.00, 95% CI 1.43–6.80, p = 0.005). Married patients showed a trend toward higher odds of receiving adjuvant radiation compared to single patients (OR 1.49, p = 0.078). Sex, race, ethnicity, income quartile, and geographical residence were not independently associated with receipt of guideline-concordant adjuvant radiation therapy.

Conclusions: Among high-risk parotid tumors, married and younger patients were independently associated with higher odds of receiving guideline-concordant adjuvant radiation, whereas race, ethnicity, income, and geographic residence were not. These findings suggest traditional sociodemographic disparities may play a limited role, and further studies are warranted to clarify these relationships.