Association between treatment delays and oncologic outcome in patients treated with surgery and radiotherapy for head and neck cancer

Vasu Tumati, Lawrence Hoang, Baran D Sumer, John M Truelson, Larry L Myers, Saad Khan, Randall S Hughes, Lucien A Nedzi, David J Sher

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: This study sought to determine the oncologic impact of delays to surgery, radiotherapy, and completion of therapy in patients with head and neck squamous cell carcinoma. Methods: The impact of biopsy to surgery (BTS) time, surgery to start of radiation time (STSR), and radiation treatment time (RTT) on locoregional recurrence (LRR), distant metastases (DMs), and cancer-specific mortality (CSM) was examined. The cumulative incidences (CI) of LRR, DMs, and CSM were examined using Fine–Gray testing. Results: A total of 277 patients treated with surgery and adjuvant radiotherapy were analyzed. On multivariable testing, BTS >50 days was associated with DM (P =.03), whereas RTT and STSR were not. RTT >43 days was associated with LRR (P =.02) in patients with non-p16-positive-oropharynx cancer. Conclusions: An increase in DM appears to be the mechanism by which prolonged time to treatment initiation leads to worse overall survival. Prolonged RTT has the greatest impact on patients with non-p16 positive oropharynx cancers.

Original languageEnglish (US)
Pages (from-to)315-321
Number of pages7
JournalHead and Neck
Volume41
Issue number2
DOIs
StatePublished - Feb 1 2019

Keywords

  • adjuvant radiation therapy
  • head and neck cancer
  • time to treatment initiation
  • treatment delays

ASJC Scopus subject areas

  • Otorhinolaryngology

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