Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 20;15(1):202.
doi: 10.1186/s13014-020-01645-w.

Impact of delays in radiotherapy of head and neck cancer on outcome

Barbara Žumer  1 , Maja Pohar Perme  2 , Simona Jereb  3 , Primož Strojan  4   5
Affiliations

Impact of delays in radiotherapy of head and neck cancer on outcome

Barbara Žumer et al. Radiat Oncol. .

Abstract

Background: In head and neck cancer (HNC), the relationship between a delay in starting radiotherapy (RT) and the outcome is unclear. The aim of the present study was to determine the impact of the amount of time before treatment intervention (TTI) and the growth kinetics of individual tumors on treatment outcomes and survival.

Methods: Two hundred sixty-two HNC patients with 273 primary tumors, treated with definitive (chemo) RT, were retrospectively analyzed. The TTI was defined as the time interval between the date of histopathologic diagnosis and the first day of the RT course. Volumetric data on 57 tumors were obtained from diagnostic and RT planning computer tomography (CT) scans in order to calculate the tumor growth kinetic parameters.

Results: No significant association between locoregional control or cause-specific hazards and TTI was found. The log hazard for locoregional recurrence linearly increased during the first 40 days of waiting for RT, although this was not significant. The median tumor volume relative increase rate and tumor volume doubling time was 3.2%/day and 19 days, respectively, and neither had any impact on locoregional control or cause-specific hazards.

Conclusion: The association between a delay in starting RT and the outcome is complex and does not harm all patients waiting for RT. Further research into imaging-derived kinetic data on individual tumors is warranted in order to identify patients at an increased risk of adverse outcomes due to a delay in starting RT.

Keywords: Head and neck cancer; Outcome; Radiotherapy; Treatment delay; Waiting time.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of TTI
Fig. 2
Fig. 2
Trend of the hazard for locoregional recurrence (a) and for index cancer-specific death (b)
Fig. 3
Fig. 3
Impact of primary tumor volume relative increase rate to disease-free survival in 45 patients with no residual disease at 10–12 weeks post-therapy
See this image and copyright information in PMC

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. World Health Organization . WHO life expectancy. 2018. Geneva: World Health Organization; 2019.
    1. Mackillop WJ, Zhou S, Groome P, Dixon P, Cummings BJ, Hayter C, et al. Changes in the use of radiotherapy in Ontario 1984-1995. Int J Radiat Oncol Biol Phys. 1999;44:355–362. - PubMed
    1. Miles EA, Clark CH, Urbano MT, Bidmead M, Dearnaley DP, Harrington KJ, et al. The impact of introducing intensity modulated radiotherapy into routine clinical practice. Radiother Oncol. 2005;77:241–246. - PubMed
    1. Grau C, Defourny N, Malicki J, Dunscombe P, Borras JM, Coffey M. Et al; on behalf of the HERO consortium. Radiotherapy equipment and departments in the European countries: final results from the ESTRO-HERO survey. Radiother Oncol. 2014;112:155–164. - PubMed

MeSH terms