Time to treatment initiation independently impacts survival in patients with head and neck squamous cell carcinoma (HNSCC), according to a new study published online ahead of print in the Journal of Clinical Oncology.1
Specifically, a time to treatment initiation greater than 46 to 52 days was most consistently associated with an increased risk of death beyond 60 days.
For the study, researchers at Fox Chase Cancer Center in Philadelphia, PA, sought to estimate the overall survival effect from increasing time to treatment initiation for patients with HNSCC. Researchers analyzed data from 51 655 patients who received curative therapy for HNSCC in the tongue, oropharynx, larynx, or hypopharynx.
Results of their analysis showed that time from diagnosis to initiation of curative treatment of 61 to 90 days vs less than 30 days was independently associated with increased risk of death (HR, 1.13; 95% CI, 1.08 – 1.19). Researchers found that a time to treatment initiation of 67 days was the optimal threshold (P < .001) in 1 analysis.
In another analysis, ranges of 46 to 52 days and 62 to 67 days were time to treatment initiation thresholds, meaning that treatment should be initiated before the 62 to 67-day range. The median overall survival for time to treatment initiation of 46 to 52 days or fewer was 71.9 months (95% CI, 70.3 – 73.5) vs 61 months (95% CI, 57 – 66.1) for 53 to 67 days and 46.6 months (95% CI, 42.8 – 50.7) for greater than 67 days (P < .001).
RELATED: Head and Neck Cancer Patients Have Higher Suicide Risk
The study also demonstrated that 25% of patients had a time to treatment initiation of greater than 46 days in 2011.
“Prolonged [time to treatment initiation] is currently affecting survival,” the authors concluded.
- Murphy CT, Galloway TJ, Handorf EA, et al. Survival impact of increasing time to treatment initiation for patients with head and neck cancer in the United States [published online ahead of print on November 30, 2015]. J Clin Oncol. doi: 10.1200/JCO.2015.61.5906.