The impact of treatment package time on survival in surgically managed head and neck cancer in the United States

Goel, Alexander N.; Frangos, Mariana I.; Raghavan, Govind; Lazaro, Stephanie L de Sam; Tang, Belicia; Chhetri, Dinesh K.; Long, Jennifer L.; John, Maie A. St.

doi:10.1016/j.oraloncology.2018.11.021

Cited by 35 publications

(34 citation statements)

References 38 publications

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“…Multivariable Cox proportional hazard regression was used to analyze the survival impact of prolonged treatment intervals, modeled as continuous variables. Optimal thresholds of DTS, SRT, and RTD that estimated the largest differences in OS were identified through recursive partitioning analysis (RPA) . Kaplan‐Meier models were then used to estimate survival based on these thresholds, with comparisons via log‐rank tests.…”

Section: Methodsmentioning

confidence: 99%

“…Kaplan‐Meier models were then used to estimate survival based on these thresholds, with comparisons via log‐rank tests. To confirm the predictive value of these cutoffs after controlling for other covariates, we performed multivariable Cox regression with DTS, SRT, and RTD modeled as continuous variables using restricted cubic splines with 4 knots with the RPA‐derived thresholds as the reference values …”

Section: Methodsmentioning

confidence: 99%

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Treatment delays in surgically managed sinonasal cancer and association with survival

et al. 2019

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Objective: To characterize treatment delays in sinonasal cancer managed with surgery and adjuvant radiation and determine the associated impact on survival.Study Design: Retrospective cohort study. Methods: We identified adults in the National Cancer Database treated for sinonasal squamous cell carcinoma with definitive surgery followed by adjuvant radiation from 2004 to 2014. We then examined intervals of diagnosis to surgery (DTS), surgery to radiation (SRT), and radiation duration (RTD). Next, we performed recursive partitioning analysis (RPA) to identify thresholds for these treatment intervals that estimated the greatest differences in survival. We determined the association of treatment delay with overall survival using Cox proportional hazards regression.Results: Among 2,267 patients included, median durations of DTS, SRT, and RTD were 32, 49, and 47 days, respectively. Predictors of treatment delay included care transitions, black race, and Medicare insurance. We identified thresholds of 26, 64, and 51 days for DTS, SRT, and RTD, respectively, as estimating the largest survival differences. Delays in SRT (hazard ratio [HR] 1.20; 95% confidence interval [CI], 1.03-1.40), and RTD (HR, 1.27; 95% CI, 1.10-1.46) beyond these thresholds independently predicted mortality. Delay in DTS beyond the RPA-derived threshold was not significantly associated with mortality after adjusting for other covariates.Conclusion: Delays in SRT and RTD intervals are associated with decreased overall survival. Median durations may serve as national benchmarks. Treatment delays could be considered quality indicators for sinonasal cancer treated with surgery and adjuvant radiation.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Treatment delays in surgically managed sinonasal cancer and association with survival

et al. 2019

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“…In separate retrospective analyses, Parsons et al and Rosenthal et al found that prolongation of TPT longer than 100 days (approximately 14 weeks) predicted for worse locoregional control and survival in combined modality treatment of mHNSCC. 9,10 Other retrospective series have reported a deleterious effect of TPT prolongation on survival with earlier cut-points of 11 weeks 12 and 87 days, respectively. 11 More robust data from prospective randomized control trials also suggests a deleterious effect of TPT prolongation in mHNSCC.…”

Section: Discussionmentioning

confidence: 97%

“…5,6 In mucosal HNSCC (mHNSCC), prolongation of treatment package time (TPT -the interval between date of surgery and completion of PORT) beyond 11 to 14 weeks reduces both locoregional control and overall survival. [7][8][9][10][11][12] Although there is radiobiologic evidence to support the minimization of treatment delays in single modality definitive radiation therapy for cutaneous SCC, 13 there is a paucity of data on the effect of TPT in combined modality treatment. 14 Therefore, the primary aim of this study was to investigate the effect of TPT on tumor control and survival outcomes in node-positive cHNSCC treated with curative surgery and PORT.…”

Section: Introductionmentioning

confidence: 99%

Treatment Package Time in Node-Positive Cutaneous Head and Neck Squamous Cell Carcinoma

Daniels

Bressel

Corry

et al. 2020

Practical Radiation Oncology

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“…These treatment interruptions would be of utmost concern for tumors in which overall treatment time significantly impacts outcomes such as head and neck cancers and cervical cancers. 14,15 On the other hand, treatment delays may also be due to strains on the healthcare system in the setting of a pandemic due to travel restrictions, availability of workforce, and/ or lack of access to hospital care. 16 If possible, travel restrictions for the general public should be tailored for patients with cancer, such as being done currently in Italy.…”

Section: Setup Of Different Treatment Delivery Counters With Dedicatementioning

confidence: 99%

The Impact of COVID-19 on Radiation Oncology and Cancer Care: A Perspective from the Cancer Belt Region of India

Marcus

Mahajan

2020

ASJO

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AbstractA pandemic coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a respiratory illness called coronavirus disease 2019 (COVID-19) that is often severe or life threatening. Considering the low immunity status of cancer patients due to multimodality treatment, they seem to be more prone to COVID-19. Given the rapidity with which the novel coronavirus (SARS-CoV-2) is spreading, we can expect an increased burden of cancer patients diagnosed with COVID-19 at oncology treatment clinics and a need to address the issues associated. As of the date of this writing, United States has been witnessing an increase in confirmed cases, not far behind are the large outbreaks of European countries. Patients with cancer may have compromised immunity due to their disease or its ongoing treatment, and early reports suggest cancer is a risk factor for severe COVID-19. Since the outbreak in Wuhan, Chinese researchers have published on their experience with COVID-19 and have highlighted high-risk groups, including the elderly and patients with comorbidities, including cancer. In one of the largest series reported from Wuhan, elderly patients were at a higher risk for disease severity with an 8.0% case fatality rate in those aged between 70 and 79 years, and 14.8% in those aged 80 years and older. The case fatality rate for cancer patients in that cohort was notably higher than noncancer patients at 5.6 versus 2.1% in the whole sample. This review focuses on the pandemic-driven strategies that need to be adopted to overcome the radiation oncology clinics burden, especially in this region of India popularly termed as the cancer belt. Although colleagues around the world have dealt with enormous service pressures in the face of natural disaster or infection previously, the global scale and challenge of COVID-19 are unprecedented. Our aim is to highlight the quintessential point that even within these circumstances the morbidity and mortality associated with cancer should not be taken lightly. Departmental protocols should be regularly upgraded to provide smooth and efficient functioning of the department.

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The impact of treatment package time on survival in surgically managed head and neck cancer in the United States

Cited by 35 publications

References 38 publications

Treatment delays in surgically managed sinonasal cancer and association with survival

Treatment delays in surgically managed sinonasal cancer and association with survival

Treatment Package Time in Node-Positive Cutaneous Head and Neck Squamous Cell Carcinoma

The Impact of COVID-19 on Radiation Oncology and Cancer Care: A Perspective from the Cancer Belt Region of India

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