Timely initiation of chemotherapy: a systematic literature review of six priority cancers – results and recommendations for clinical practice

Alexander, Marliese; Blum, Robert; Burbury, Kate; Coutsouvelis, John; Dooley, Michael; Fazil, O.; Griffiths, T.R. Leyshon; Ismail, Hilmy; Joshi, Shivam; Love, Neil; Opat, Stephen; Parente, Phillip; Porter, Neil; Ross, Elizabeth M.; Siderov, Jim; Thomas, P.; White, Shane; Kirsa, Sue; Rischin, Danny

doi:10.1111/imj.13190

Cited by 36 publications

(37 citation statements)

References 69 publications

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“…4 Most studies show no relationship between time-tochemotherapy and their survival rate. 26 However, it should be noted that in these review articles, the number of cases collected is generally very low, with the highest number of patients only 10 583. 26 Another study showed time intervals from diagnosis to treatment were not associated with survival outcomes in NSCLC.…”

Section: Discussionmentioning

confidence: 87%

“…26 However, it should be noted that in these review articles, the number of cases collected is generally very low, with the highest number of patients only 10 583. 26 Another study showed time intervals from diagnosis to treatment were not associated with survival outcomes in NSCLC. 27 In this previous study, they discussed NSCLC patients with different treatment such as surgery, radiotherapy, systemic therapy and palliative care, which were not discussed in our study.…”

Section: Discussionmentioning

confidence: 87%

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Effect of time interval from diagnosis to treatment for non-small cell lung cancer on survival: a national cohort study in Taiwan

et al. 2020

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ObjectivesThis study aimed to determine if treatment delay after non-small cell lung cancer (NSCLC) diagnosis impacts patient survival rate.Study designThis study is a natural experiment in Taiwan. A retrospective cohort investigation was conducted from 2004 to 2010, which included 42 962 patients with newly diagnosed NSCLC.MethodsWe identified 42 962 patients with newly diagnosed NSCLC in the Taiwan Cancer Registry from 2004 to 2010. We calculated the time interval between diagnosis and treatment initiation. All patients were followed from the index date to death or the end of 2012. Cox proportional hazard models were used to examine the relationship between mortality and time interval.ResultsWe included 42 962 patients (15 799 men and 27 163 women) with newly diagnosed NSCLC. The mortality rate exhibited a significantly positive correlation to time interval from cancer diagnosis to treatment initiation. The adjusted HRs ranged from 1.04 to 1.08 in all subgroups time interval more than 7 days compared with the counterpart subgroup of the interval from cancer diagnosis to treatment ≤7 days. The trend was also noted regardless of the patients with lung cancer in stage I, stage II and stage III.ConclusionsThere is a major association between time to treat and mortality of patients with NSCLC, especially in stages I and II. We suggest that efforts should be made to minimise the interval from diagnosis to treatment while further study is ongoing to determine causation.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 87%

Effect of time interval from diagnosis to treatment for non-small cell lung cancer on survival: a national cohort study in Taiwan

et al. 2020

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“…Moreover, Sun Z. et al, [16] emphasized the importance of the timely initiation, which suggested delays beyond 6 weeks were associated with a compromised survival. In addition, Alexander M. et al, [6] systematic analyzed 7 articles about the initiation intervals, concluded that PAC should commence within 4 -8 weeks for curative colorectal neoplasm patients. More recent study by Nachiappan S. et al, [17] put forward that people would be benefit from initiation of PAC within 8 weeks regardless of reoperation.…”

Section: Discussionmentioning

confidence: 99%

“…Updated international guidelines recommend that maximum interval from the development of a management plan to chemotherapy initiation is 12 weeks for PAC. Most clinical trials mandate the initiation of adjuvant chemotherapy for surgically resected colorectal cancer within 4 -8 weeks post-surgery [6]. A large, randomized study conducted with Stage II/III CRC patients in the Hospital Episode Statistics (HES) reported that PAC initiation beyond 8 weeks significantly reduced overall survival (OS) in patients, compared to those who received it within 8 weeks, and every 2 weeks increments in the delay accompanied by progressively worse OS [7].…”

Section: Introductionmentioning

confidence: 99%

Stage II/III Rectal Cancer Patients Benefit from Extremely Early Initiation of Postoperative Adjuvant Chemotherapy: A Retrospective Study

Xiao¹,

Zhu²,

Chen³

et al. 2019

JCT

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Background: For Stage II/III rectal cancer patients, curative resection is the primary treatment, prescribing of postoperative adjuvant chemotherapy (PAC) is regarded as a standard therapy. The interval between surgery and the initiation of PAC is usually within 8 weeks. However, the optimal cutoff is still controversial. This study aimed to explore the impact of extremely early initiation of PAC for II/III rectal cancer. Methods: Patients with Stage II/III rectal cancer treated from January 2013 to December 2015 were retrospectively collected at the Department of Tongji Hospital. According to the starting point of PAC, patients were categorized into two groups: extremely early group (The interval of PAC ≤ 2 weeks) and normal group (The interval of PAC within 3-5 weeks). For the sake of evaluating the effectiveness of different intervals, Overall Survival rate (OS), Progress-Free Survival rate (PFS) and Recurrence or Metastasis Rate (RMR) were analyzed, as well as the Quality of Life Score. To estimate the safety of the extremely early PAC, we evaluated the first post chemotherapy adverse reactions and defecation ability, and analyzed the variance laboratory indexes around the first postoperative adjuvant chemotherapy. Results: A total of 267 patients were included in this study. Compared to normal group (192 cases), extremely early group (75 cases) of patients attained a better tendency of OS and PFS, although there were no significant statistical differences (OS: P = 0.0930; PFS: P = 0.1058). However, the RMR was significant lower (P = 0.0452) and the Quality of Life Score was significantly higher (P = 0.0090) in extremely early group. Multivariate analysis also showed that extremely early group had better defecation ability (P = 0.0149) and less side reactions of post chemotherapy, such as vomiting (P < 0.

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“…The study by Wright et al [8] reported that a TTC of 6 weeks or less did not influence OS (overall survival rates). However, the review article by Alexander et al [9], recommends starting chemotherapy within 4 weeks of surgery.…”

Section: Introductionmentioning

confidence: 99%

An analysis of the influence of infection on overall survival rates, following modified posterior pelvic exenteration for advanced ovarian cancer

Szymankiewicz¹,

Dziobek²,

Sznajdorwska³

et al. 2018

Ginekol Pol

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Objectives:The aim of our study was to determine the association between the appearance of infection after modified posterior pelvic exenteration (MPE) and the time to adjuvant chemotherapy (TTC), and to examine whether infection has any impact on clinical results by delaying the start of chemotherapy. Material and methods:Our retrospective study analyzed 77 patients who had undergone MPE followed by adjuvant chemotherapy. Postoperatively, either there was no residual tumor or, the residual tumor was less than 2.5 mm, in 76.7% of the study patients. Our study group was divided into two subgroups for comparison; the first group consisted of 41 patients with postoperative infections, and the second group of 36 patients had no infections. The infections of the first group were monitored during a 90-day postoperative period. Median TTC and overall survival rates (OS) were determined for those patients who developed an infection as well as for those who did not. Results:The expected 5-year survival rate was 0.40 (SD = 0.09) for those patients without infection and 0.17 (SD = 0.07) for those patients with infection. The survival curves of patients with infection and those without infection were significantly different statistically (p = 0.038). The median TTC differed significantly for those patients who developed infection compared with those patients who did not develop infection (37 days compared with 27.5 days respectively, p = 0.024); and patients without infection were statistically more likely to receive chemotherapy within 25 days following surgery than in the subsequent 25-42-day period compared with those patients who did develop infection (p = 0.048). No statistically significant differences were found between the two groups in relation to results following the initiation of chemotherapy during the first 42 days postoperatively (p = 0.445). Conclusions:The absence of postoperative infection was associated with better survival rates. Patients with infection experienced a longer time interval between surgery and the start of chemotherapy, without negative impact to their overall survival rates.

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Timely initiation of chemotherapy: a systematic literature review of six priority cancers – results and recommendations for clinical practice

Cited by 36 publications

References 69 publications

Effect of time interval from diagnosis to treatment for non-small cell lung cancer on survival: a national cohort study in Taiwan

Effect of time interval from diagnosis to treatment for non-small cell lung cancer on survival: a national cohort study in Taiwan

Stage II/III Rectal Cancer Patients Benefit from Extremely Early Initiation of Postoperative Adjuvant Chemotherapy: A Retrospective Study

An analysis of the influence of infection on overall survival rates, following modified posterior pelvic exenteration for advanced ovarian cancer

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