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Meta-Analysis
. 2025 Dec;282(12):6017-6027.
doi: 10.1007/s00405-025-09517-3. Epub 2025 Jun 21.

Treatment package time (TPT) and surgery to post-operative radiotherapy (S-PORT) interval in head and neck cancers: A systematic review and meta-analysis

Mario Sánchez-Canteli  1   2   3 , Juana M García-Pedrero  4   5 , Juan P Rodrigo  4   5
Affiliations
Meta-Analysis

Treatment package time (TPT) and surgery to post-operative radiotherapy (S-PORT) interval in head and neck cancers: A systematic review and meta-analysis

Mario Sánchez-Canteli et al. Eur Arch Otorhinolaryngol. 2025 Dec.

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.

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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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