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

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3 Citations (Scopus)

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)
JournalHead and Neck
DOIs
StateAccepted/In press - Jan 1 2018

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Head and Neck Neoplasms
Radiotherapy
Radiation
Neoplasm Metastasis
Oropharyngeal Neoplasms
Therapeutics
Recurrence
Biopsy
Adjuvant Radiotherapy
Mortality
Neoplasms
Survival
Incidence

Keywords

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

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

@article{39536e337476450eab0a8ccde12f8399,
title = "Association between treatment delays and oncologic outcome in patients treated with surgery and radiotherapy for head and neck cancer",
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.",
keywords = "adjuvant radiation therapy, head and neck cancer, time to treatment initiation, treatment delays",
author = "Vasu Tumati and Lawrence Hoang and Sumer, {Baran D} and Truelson, {John M} and Myers, {Larry L} and Saad Khan and Hughes, {Randall S} and Nedzi, {Lucien A} and Sher, {David J}",
year = "2018",
month = "1",
day = "1",
doi = "10.1002/hed.25457",
language = "English (US)",
journal = "Head and Neck",
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TY - JOUR

T1 - Association between treatment delays and oncologic outcome in patients treated with surgery and radiotherapy for head and neck cancer

AU - Tumati, Vasu

AU - Hoang, Lawrence

AU - Sumer, Baran D

AU - Truelson, John M

AU - Myers, Larry L

AU - Khan, Saad

AU - Hughes, Randall S

AU - Nedzi, Lucien A

AU - Sher, David J

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - adjuvant radiation therapy

KW - head and neck cancer

KW - time to treatment initiation

KW - treatment delays

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