The effect of time from surgery to commencing adjuvant radiotherapy for patients with head and neck squamous cell carcinoma

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-02-01 DOI:10.1016/j.oraloncology.2024.107138

J.M. Price , K. Garcez , C. Hughes , L.W. Lee , H.M. Mistry , G. Motamedi-Ghahfarokhi , G.J. Price , C.M. West , D.J. Thomson

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引用次数: 0

Abstract

Introduction

Studies reported inferior outcomes when radiotherapy starts >6–8 weeks post-surgery for head and neck squamous cell carcinoma (HNSCC) but are limited due to time variable dichotomization. We assessed the relationship between survival and the time between surgery and radiotherapy as a continuous variable, hypothesising there would be no change in patients’ survival at 6–8 weeks post-surgery.

Methods/Materials

Inclusion criteria: patients with HNSCC who underwent surgery and adjuvant (chemo)radiotherapy, Jan 2014-Dec 2020. A sub-cohort included patients with oral cavity squamous cell carcinoma (OCSCC) treated at the same institution, Jan 2016-Dec 2020. The primary endpoint was overall survival (OS); a multivariable Cox model was fitted. For the OCSCC sub-cohort, the endpoint of interest was progression-free survival (PFS); a multivariable competing risk regression model was fitted.

Results

386 patients with HNSCC were included (main cohort). The median time between surgery and radiotherapy was 44 days (IQR: 14 days). Plotting time intervals vs log(hazard) did not demonstrate a threshold time where risk of death increases. The time interval between surgery and radiotherapy was not associated with OS (HR 1.00; 95 % CI 0.99–1.02; p = 0.4).

In the sub-cohort of 208 patients with OCSCC, the time interval between surgery and radiotherapy was not associated with increased risk of cancer vs competing events (HR 1.01; 95 % CI 0.99–1.03; p = 0.5).

Conclusion

Increasing time interval between surgery and radiotherapy was not associated with inferior survival outcomes. We suggest patients are considered for radiotherapy >6–8 weeks post-surgery and that no threshold is considered for patient selection.

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头颈部鳞状细胞癌患者手术至开始辅助放疗时间的影响。

研究报道头颈部鳞状细胞癌（HNSCC）术后6-8周开始放疗的预后较差，但由于时间变量二分法的限制。我们评估了生存率与手术和放疗之间的时间之间的关系，作为一个连续变量，假设术后6-8周患者的生存率没有变化。方法/材料：纳入标准：2014年1月- 2020年12月，行手术+辅助（化疗）放疗的HNSCC患者。亚队列包括2016年1月至2020年12月在同一机构接受治疗的口腔鳞状细胞癌（OCSCC）患者。主要终点是总生存期（OS）；拟合多变量Cox模型。对于OCSCC亚队列，关注的终点是无进展生存期（PFS）；拟合了多变量竞争风险回归模型。结果：386例HNSCC患者被纳入（主队列）。手术至放疗的中位时间为44天（IQR: 14天）。绘制时间间隔与对数（危险）的图并没有显示死亡风险增加的阈值时间。手术和放疗之间的时间间隔与OS无关(HR 1.00；95% ci 0.99-1.02；p = 0.4)。在208例OCSCC患者的亚队列中，手术和放疗之间的时间间隔与癌症与竞争事件的风险增加无关(HR 1.01；95% ci 0.99-1.03；p = 0.5)。结论：手术与放疗间隔时间的延长与生存预后不相关。我们建议患者在术后6-8周考虑放射治疗，不考虑患者选择的阈值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.