Treatment package time (TPT) and surgery to post-operative radiotherapy (S-PORT) interval in head and neck cancers: A systematic review and meta-analysis
- PMID: 40542897
- DOI: 10.1007/s00405-025-09517-3
Treatment package time (TPT) and surgery to post-operative radiotherapy (S-PORT) interval in head and neck cancers: A systematic review and meta-analysis
Abstract
Background: The impact of key treatment intervals on head and neck squamous cell carcinoma (HNSCC) survival remains unclear.
Methods: This systematic review and meta-analysis, conducted following PRISMA guidelines, assessed 22 cohort studies including 322,569 patients. The mean threshold for prolonged total treatment package time (TPT) was 95.21 days, while for surgery-to-postoperative radiotherapy (S-PORT), it was 6.9 weeks.
Results: Both prolonged TPT and S-PORT intervals were significantly associated with reduced survival (TPT: HR = 1.25; S-PORT: HR = 1.03; p < 0.0001). However, the negative impact of extended TPT was more pronounced compared to S-PORT delays.
Conclusion: These findings suggest that minimizing TPT delays is critical for optimizing HNSCC outcomes. However, substantial heterogeneity across studies limits the generalizability of results. Further research is needed to establish standardized treatment timelines and improve survival rates in HNSCC patients.
Keywords: Head and neck squamous cell carcinoma; Prognosis; Surgery-to-postoperative radiotherapy; Survival outcomes; Total treatment package time.
© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Conflict of interest statement
Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: All authors agree to publish. Conflict of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Competing interests: The authors declare that they have no conflict of interest.
Comment in
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Comment on: "Prognostic Significance of Surgery-to-Postoperative Radiation Therapy Interval (S-PORT) and Total Treatment Package Time (TPT) in HNSCC".Eur Arch Otorhinolaryngol. 2025 Jul 30. doi: 10.1007/s00405-025-09595-3. Online ahead of print. Eur Arch Otorhinolaryngol. 2025. PMID: 40739371 No abstract available.
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References
-
- Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A (2024) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 74(3):229–263. https://doi.org/10.3322/caac.21834 - DOI
-
- Graboyes EM, Garrett-Mayer E, Ellis MA, Sharma AK, Wahlquist AE, Lentsch EJ, Nussenbaum B, Day TA (2017) Effect of time to initiation of postoperative radiation therapy on survival in surgically managed head and neck cancer. Cancer 123(24):4841–4850. https://doi.org/10.1002/cncr.30939 - DOI
-
- Brinkerhoff BT, Choong NW, Massey BL, Gore EM, Firat SY, Wong SJ, Campbell BH, Schapira RM, Visotcky AM, Tripp PM (2012) Diagnosis to treatment interval and outcome in patients with locally-advanced squamous cell carcinoma of the head and neck in a veterans affairs medical center. J Cancer Sci Ther 4(5):111–115. https://doi.org/10.4172/1948-5956.1000122 - DOI
-
- Villemure-Poliquin N, Fu R, Gaebe K, Kwon J, Cohen M, Ruel M, Ayoo K, Bailey A, Galapin M, Hallet J, Eskander A (2024) Delayed diagnosis to treatment interval (DTI) in head & neck cancers - A systematic review and meta-analysis. Oral Oncol. Published online November 21, 2024. https://doi.org/10.1016/j.oraloncology.2024.107106
-
- Caudell JJ, Gillison ML, Maghami E, Spencer S, Pfister DG, Adkins D, Birkeland AC, Brizel DM, Busse PM, Cmelak AJ, Colevas AD, Eisele DW, Galloway T, Geiger JL, Haddad RI, Hicks WL, Hitchcock YJ, Jimeno A, Leizman D, Mell LK, Mittal BB, Pinto HA, Rocco JW, Rodriguez CP, Savvides PS, Schwartz D, Shah JP, Sher D, St John M, Weber RS, Weinstein G, Worden F, Yang Bruce J, Yom SS, Zhen W, Burns JL, Darlow SD (2022) NCCN Guidelines® insights: Head and neck cancers, version 1.2022. J Natl Compr Canc Netw 20(3):224–234. https://doi.org/10.6004/jnccn.2022.0016 - DOI
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