Is there a delay in treatment initiation of head and neck cancer patients in our country?
Authors:
M. Wzošová; M. Profant
; Miroslav Tedla
Authors place of work:
Klinika otorinolaryngológie, chirurgie hlavy a krku LF UK a UNB, Bratislava
Published in the journal:
Otorinolaryngol Foniatr, 69, 2020, No. 2, pp. 70-74.
Category:
Original Article
Summary
Introduction: Delay in treatment initiation of head and neck cancer patients is associated with progression of disease and shortened survival. In this work, we investigate if there is a treatment delay in head and neck cancer patients at our institution and if primary non-surgical treatment or management of patients at multiple institutions are associated with treatment delay.
Methods: In patients with newly diagnosed laryngeal cancer, treated at Department of Otolaryngology, Head and Neck Surgery, LFUK and UNB Bratislava between the years 2014 and 2018, time to treatment initiation (TTI) was calculated. Patients were divided into three groups according to TTI and risk of decreased survival: less than 45 days, 45 to 73 days and more than 73 days. Median TTI values and the number of patients in the three groups were compared between patients treated surgically and non-surgically and between patients managed only at our department and those sent with established diagnosis.
Results: Median TTI value in our cohort was 35 days. Twenty-eight percent of patients were in risk of delay, in 5% of patients there was a delay. Median TTI value in patients who were diagnosed and treated at our department was 13 days shorter than in patients who were sent to us with established diagnosis. There was a delay in treatment initiation of 13.51% non-surgically treated patients, 45.95% were in risk of delay.
Conclusion: There is a delay in treatment initiation of head and neck cancer patients. Waiting time is longer in patients managed at multiple institutions and in those treated non-surgically. It is necessary to work on decreasing it - by coordination of treatment in multidisciplinary team, centralisation of care, performance of biopsy at outpatient clinic, and in other ways.
Keywords:
head and neck cancer – Quality of care – treatment delay – time to treatment initiation – laryn-geal cancer
Zdroje
1. Caudell, J. J., Locher, J. L., Bonner, J. A.: Diagnosis-to-treatment interval and control of locoregionally advanced head and neck cancer. Arch Otolaryngol Head Neck Surg, 137, 2011, 3, s. 282–285.
2. Coca-Pelaz, A., Takes, R. P., Hutcheson, K., et al.: Head and neck cancer: a review of the impact of treatment delay on outcome. Adv Ther, 35, 2018; 2, s. 153–160.
3. Fortin, A., Bairati, I., Albert, M., et al.: Effect of treatment delay on outcome of patients with early-stage head-and-neck carcinoma receiving radical radiotherapy. Int J Radiat Oncol Biol Phys, 52, 2002, 4, s. 929–936.
4. Guizard, A. V., Dejardin, O., Launay, L., et al.: What are the real waiting times for therapeutic management of head and neck cancer: a study in the general population in the north–west of France. Eur Arch Otorhinolaryngol, 273, 2016, 11, s. 3951–3958.
5. Hansen, O., Larsen, S., Bastholt, L., et al.: Duration of symptoms: impact on outcome of radiotherapy in glottic cancer patients. Int J Radiat Oncol Biol Phys, 61, 2005, 3, s. 789–794.
6. van Harten, M. D. C., de Ridder, M., Hamming-Vrieze, O., et al.: The association of treatment delay and prognosis in head and neck squamous cell carcinoma (HNSCC) patients in a Dutch comprehensive cancer center. Oral Oncol., 50, 2014, 4, s. 282–290.
7. van Harten, M. D. C., Hoebers, F. J., Kross, K. W., et al.: Determinants of treatment waiting times for head and neck cancer in the Netherlands and their relation to survival. Oral Oncol, 51, 2015, 3, s. 272–278.
8. Jensen, A. R., Nellemann, H. M., Overgaard, J.: Tumor progression in waiting time for radiotherapy in head and neck cancer. Radiotherapy and oncology. 84, 2007, 1, s. 5–10.
9. Kompelli, A. R., Li, H., Neskey, D. M.: Impact of delay in treatment initiation on overall survival in laryngeal cancers. Otolaryngol–Head Neck Surg, 160, 2019, 4, s. 651–657.
10. Leon, X., de Vega, M., Orus, C., et al.: The effect of waiting time on local control and survival in head and neck carcinoma patients treated with radiotherapy. Radiother Oncol, 66, 2003, 3, s. 277–281.
11. Liang, H., Xiang, Y. Q., Lv, X., et al.: Survival impact of waiting time for radical radiotherapy in nasopharyngeal carcinoma: a large institution-based cohort study from an endemic area. Eur J Cancer, 73, 2017, 73, s. 48–60.
12. Mackillop, W. J., Bates, J. H., O’Sullivan, B., et al.: The effect of delay in treatment on local control by radiotherapy. Int J Radiat Oncol Biol Phys, 34, 1996, 34, s. 243–250.
13. Murphy, C. T., Galloway, T. J., Handorf, E. A., et al.: Survival impact of increasing time to treatment initiation for patients with head and neck Cancer in the United States. J Clin Oncol, 34, 2016, 2, s. 169–178.
Štítky
Audiology Paediatric ENT ENT (Otorhinolaryngology)Článok vyšiel v časopise
Otorhinolaryngology and Phoniatrics
2020 Číslo 2
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