由于放射治疗相关因素的差异，医院间在头颈癌（HNC）存活率方面可能存在不平等现象。本研究调查了来自澳大利亚的HNC患者的数据收集、初级放射治疗和存活的医院间变异情况。从澳大利亚七家医院的肿瘤信息系统（OIS）中提取了3,182名接受根治性放射治疗、部分伴有手术或化疗的、原发性非转移性头颈部鳞状细胞癌的成年患者的数据（2000-2017年）。死亡数据通过记录链接从国家死亡指数获取。多变量Cox回归用于评估存活与医院之间的关联。发现医院间存在数据收集、初级放射治疗剂量和五年HNC相关死亡的差异。完成11个字段的比例范围在66%至98%之间。根据医院的不同，初级放射治疗治疗Tis-T1N0喉部和任何阶段口腔腔和咽部癌症的时间校正生物等效剂量（EQD2T）存在显著差异，与澳大利亚放射治疗指南存在明显偏离。增加的EQD2T剂量与所有患者和接受初级放射治疗的患者的五年HNC相关死亡风险降低有关。医院、肿瘤部位以及T和N分型也被确定为所有接受放射治疗的患者的五年HNC相关死亡的独立预后因素。在澳大利亚医院治疗的患者中存在HNC相关死亡的未解释差异。 OIS中可用的例行收集的数据不足以解释存活的差异。需要创新的数据收集、提取和分类方法来指导临床实践。版权所有©2023年，Elsevier B.V.发表。

Inter-hospital inequalities in head and neck cancer (HNC) survival may exist due to variation in radiotherapy treatment-related factors. This study investigated inter-hospital variation in data collection, primary radiotherapy treatment, and survival in HNC patients from an Australian setting.Data collected in oncology information systems (OIS) from seven Australian hospitals was extracted for 3,182 adults treated with curative radiotherapy, with or without surgery or chemotherapy, for primary, non-metastatic squamous cell carcinoma of the head and neck (2000-2017). Death data was sourced from the National Death Index using record linkage. Multivariable Cox regression was used to assess the association between survival and hospital.Inter-hospital variation in data collection, primary radiotherapy dose, and five-year HNC-related death was detected. Completion of eleven fields ranged from 66%-98%. Primary radiotherapy treated Tis-T1N0 glottic and any stage oral cavity and oropharynx cancers received significantly different time-corrected biologically equivalent dose in two gray fractions (EQD2T) by hospital, with observed deviation from Australian radiotherapy guidelines. Increased EQD2T dose was associated with a reduced risk of five-year HNC-related death in all patients and those treated with primary radiotherapy. Hospital, tumour site, and T and N classification were also identified as independent prognostic factors for five-year HNC-related death in all patients treated with radiotherapy.Unexplained variation exists in HNC-related death in patients treated at Australian hospitals. Available routinely collected data in OIS are insufficient to explain variation in survival. Innovative data collection, extraction, and classification practices are needed to inform clinical practice.Copyright © 2023. Published by Elsevier B.V.