Survival and overall treatment time after postoperative radio(chemo)therapy in patients with head and neck cancer

Tribius, Silke; Donner, Johanna; Pazdyka, Henning; Münscher, Adrian; Gröbe, Alexander; Petersen, Cordula; Krüll, Andreas; Tennstedt, Pierre

doi:10.1002/hed.24407

Cited by 40 publications

(58 citation statements)

References 22 publications

(44 reference statements)

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“…Three articles 18,20,30 used a national cancer registry as a data source and 2 were single-institution studies. 19,40 Three studies 18,20,40 included a heterogeneous grouping of head and neck subsites and 2 were subsite specific (oral cavity). 19,30 Of the 5 studies, 4 found an association between prolonged TPT and poorer oncologic outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…19,30 Of the 5 studies, 4 found an association between prolonged TPT and poorer oncologic outcomes. 18–20,40 The 1 study that did not find an association between TPT and survival compared a TPT threshold of 161 days or more with a TPT threshold of less than 136 days. 30 In the studies that found an association between prolonged TPT and poorer survival, the threshold at which prolonged TPT correlated with poorer oncologic outcomes varied from 11 weeks or more (77 days) to 100 days or more.…”

Section: Resultsmentioning

confidence: 99%

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Association of Treatment Delays With Survival for Patients With Head and Neck Cancer

Graboyes

Kompelli

Neskey

et al. 2019

JAMA Otolaryngol Head Neck Surg

213

313

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IMPORTANCE Delays in the delivery of care for head and neck cancer (HNC) are a key driver of poor oncologic outcomes and thus represent an important therapeutic target. OBJECTIVE To synthesize information about the association between delays in the delivery of care for HNC and oncologic outcomes. EVIDENCE REVIEW A systematic review of the English-language literature in PubMed/MEDLINE and Scopus published between January 1, 2007, and February 28, 2018, was performed to identify articles addressing the association between treatment delays and oncologic outcomes for patients with HNC. Articles that were included (1) addressed cancer of the oral cavity, oropharynx, hypopharynx, or larynx; (2) discussed patients treated in 2004 or later; (3) analyzed time of diagnosis to treatment initiation (DTI), time from surgery to the initiation of postoperative radiotherapy, and/or treatment package time (TPT; the time from surgery through the completion of postoperative radiotherapy); (4) included a clear definition of treatment delay; and (5) analyzed the association between the treatment time interval and an oncologic outcome measure. Quality assessment was performed using the Institute of Health Economics Quality Appraisal Checklist for Case Series Studies. FINDINGS A total of 18 studies met inclusion criteria and formed the basis of the systematic review. Nine studies used the National Cancer Database and 6 studies were single-institution retrospective reviews. Of the 13 studies assessing DTI, 9 found an association between longer DTI and poorer overall survival; proposed DTI delay thresholds ranged from more than 20 days to 120 days or more. Four of the 5 studies assessing time from surgery to the initiation of postoperative radiotherapy (and all 4 studies assessing guideline-adherent time to postoperative radiotherapy) found an association between a timely progression from surgery to the initiation of postoperative radiotherapy and improved overall or recurrence-free survival. Of the 5 studies examining TPT, 4 found that prolonged TPT correlated with poorer overall survival; proposed thresholds for prolonged TPT ranged from 77 days or more to more than 100 days. CONCLUSIONS AND RELEVANCE Timely care regarding initiation of treatment, postoperative radiotherapy, and TPT is associated with survival for patients with HNC, although significant heterogeneity exists for defining delayed DTI and TPT. Further research is required to standardize optimal time goals, identify barriers to timely care for each interval, and design interventions to minimize delays.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Association of Treatment Delays With Survival for Patients With Head and Neck Cancer

Graboyes

Kompelli

Neskey

et al. 2019

JAMA Otolaryngol Head Neck Surg

213

313

View full text Add to dashboard Cite

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“…The impact of the TI from surgery to adjuvant therapy (radiation or concurrent chemoradiation) has been studied mainly in breast, endometrial, and head and neck cancers [101112132223]. Several retrospective cohort studies have found that a longer TI is associated with poor oncological outcomes of these cancers [10111222]. Recently, a study in 308 endometrial cancer patients found that delay (≥9 weeks) in beginning adjuvant RT after hysterectomy was associated with poor survival outcomes [23].…”

Section: Discussionmentioning

confidence: 99%

“…However, patients occasionally face a delay in starting their adjuvant therapy due to many factors including comorbid medical diseases, surgical complications, and availability of radiation facilities [891011]. In less developed countries such as Thailand with a rather high incidence of cervical cancer and limited resources in many settings (such as a shortage of radiation oncologists and/or equipment), a delay in starting adjuvant therapy is a major public health problem.…”

Section: Introductionmentioning

confidence: 99%

“…Various studies have proposed that the time interval (TI) from surgery to adjuvant therapy (radiation, concurrent chemoradiation, or chemotherapy) can have an impact in many types of cancer such as breast, colorectal, endometrial, head and neck cancers, and glioblastoma [89101112]. Ahmad et al [12] studied 195 endometrial cancer patients who received postoperative whole pelvic radiation and found that a delay in radiation therapy (RT) of >6 weeks was an independent significant predictor for poor disease-specific survival (p<0.005) and a marginally significant variable for decreased local control.…”

Section: Introductionmentioning

confidence: 99%

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Impact of time interval between radical hysterectomy with pelvic node dissection and initial adjuvant therapy on oncological outcomes of early stage cervical cancer

et al. 2017

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ObjectiveTo determine the impact of time interval (TI) from radical hysterectomy with pelvic node dissection (RHND) to adjuvant therapy on oncological outcomes in cervical cancer.MethodsThe study included 110 stage IA2–IB1 cervical cancer patients who underwent RHND and adjuvant therapy. The patients were divided into 2 groups based on the cut-off points of TI of 4 and 6 weeks, respectively. The associations of TI and clinicopathologic factors with oncological outcomes were evaluated using Cox proportional-hazards regression.ResultsThe median TI was 4.5 weeks. There were no statistical differences in 5-year recurrence-free survival (RFS) (89.2% vs. 81.0%, and 83.2% vs. 100.0%) or 5-year overall survival (OS) rates (90.9% vs. 97.2%, and 93.2% vs. 100.0%) between patients according to TI (≤4 vs. >4, and ≤6 vs. >6 weeks, respectively). Deep stromal invasion (p=0.037), and parametrial involvement (PI) (p=0.002) were identified as independent prognostic factors for RFS, together with the interaction between TI and squamous cell carcinoma histology (p<0.001). In patients with squamous cell carcinoma, a TI longer than 4 weeks was significantly associated with a worse RFS (hazard ratio [HR]=15.8; 95% confidence interval [CI]=1.4–173.9; p=0.024). Univariate analysis showed that only tumor size (p=0.023), and PI (p=0.003) were significantly associated with OS.ConclusionDelay in administering adjuvant therapy more than 4 weeks after RHND in early stage squamous cell cervical cancer results in poorer RFS.

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Association of Survival With Shorter Time to Radiation Therapy After Surgery for US Patients With Head and Neck Cancer

Harris

Chen

Orosco

et al. 2018

JAMA Otolaryngol Head Neck Surg

164

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Survival and overall treatment time after postoperative radio(chemo)therapy in patients with head and neck cancer

Abstract: Overall treatment time is important for survival in patients with head and neck cancer. Completing treatment within as short a timeframe as possible may be associated with longer OS and DFS. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1058-1065, 2016.

Cited by 40 publications

References 22 publications

Association of Treatment Delays With Survival for Patients With Head and Neck Cancer

Association of Treatment Delays With Survival for Patients With Head and Neck Cancer

Impact of time interval between radical hysterectomy with pelvic node dissection and initial adjuvant therapy on oncological outcomes of early stage cervical cancer

Association of Survival With Shorter Time to Radiation Therapy After Surgery for US Patients With Head and Neck Cancer

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