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Prolonged treatment delay did not affect outcomes in SCCHN
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Multidisciplinary Head and Neck Cancer Symposium
No association was found between diagnosis to treatment interval and tumor control outcomes in patients with squamous cell carcinoma of the head and neck. However, patients with poor Karnofsky performance status, black patients and patients treated with intensity-modulated radiation therapy all had prolonged diagnosis to treatment interval.
Jimmy J. Caudell Jr., MD, PhD, assistant professor of radiation oncology at the University of Mississippi, Jackson, presented the findings at the Multidisciplinary Head & Neck Cancer Symposium in Chandler, Ariz.
Prolonged treatment delay from the time of diagnosis may often occur in patients with locoregionally advanced head and neck cancer due to social, dental, nutritional and radiotherapy planning procedures that need to be resolved prior to treatment initiation, according to researchers.
To assess factors affecting treatment delay, researchers analyzed data from 426 patients with SCCHN treated with radiotherapy from 1995 to 2007 at the University of Alabama-Birmingham. The median follow-up was 42 months.
The median diagnosis to treatment interval was 34 days. Longer than median diagnosis to treatment interval was associated with treatment off protocol (P=.002), black ethnicity (P=.005), insurance type (P<.001), lower Karnofsky performance status (P=.003), primary site (P=.01) and use of IMRT (P<.001).
Use of IMRT (P<.001), lower Karnofsky performance status (P=.02) and black ethnicity (P=.04) remained significant for longer diagnosis to treatment interval, in a regression analysis.
Longer diagnosis to treatment interval was not significantly associated, however, with locoregional control (P=.11), distant metastasis-free survival (P=.32) or OS (P=.07). No difference was observed in locoregional control (P=.2) or OS (P=.4), even when the lowest quartile for diagnosis to treatment interval (<24 days) was compared with the highest quartile (>51 days).
“If we can identify these patients or processes to shorten delay to treatment, we may improve patient satisfaction,” Caudell said during a presentation. – by Christen Haigh
For more information:
- Caudell JJ. #13. Presented at: Multidisciplinary Head and Neck Cancer Symposium; Feb. 25-27, 2010; Chandler, Ariz.
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