Impact of treatment time and waiting time on outcome for esophageal squamous cell carcinoma receiving definitive chemoradiotherapy.

IF 3.3 2区医学 Q2 ONCOLOGY

Radiation Oncology Pub Date : 2025-07-16 DOI:10.1186/s13014-025-02687-8

Geng Xiang, Xiaomeng Wang, Cong Zhang, Guangjin Chai, Bo Lyu, Yutian Yin, Bin Wang, Lina Zhao

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引用次数: 0

Abstract

Purpose: To assess the effect of treatment time and waiting time on clinical outcome for patients with esophageal squamous cell carcinoma (ESCC) treated with definitive concurrent chemoradiotherapy (CCRT).

Methods and materials: A retrospective analysis was conducted on ESCC patients treated with definitive CCRT between 2008 and 2024 at Xijing hospital. Analyses were performed according to the following separate definitions of treatment time and waiting time: (1) theoretical minimal radiotherapy time (TMRT); (2) overall treatment time (OTT); (3) exceeding time (ET); (4) time to start of radiotherapy (TSR); (5) overall waiting time (OWT). Associations between treatment time and waiting time and survival outcome were investigated using Cox regression analyses.

Results: A total of 541 patients were studied and prolonged treatment time and waiting time were common. Overall, the median TMRT, OTT, ET, TSR, and OWT were 38 days [interquartile range (IQR): 38-40 days], 43 days (IQR: 40-47 days), 4 days (IQR: 2-7 days), 88 days (IQR: 62-126 days), and 21 days (IQR: 14-31 days), respectively. Multivariate analysis revealed that delay of treatment time and waiting time has no effect on overall survival (OS), locoregional relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and progression-free survival (PFS) (all p > 0.05). In the subgroup of patients with T1-2 ESCC disease, the TSR < 72 days group had significantly more favorable OS (p = 0.009), LRFS (p = 0.003), and PFS (p = 0.022) compared with TSR ≥ 72 days group.

Conclusions: Delay of treatment time and waiting time has no effect on OS, LRFS, DMFS, and PFS. However, longer TSR was found to be associated with diminished survival outcomes for T1-2 stage rather than T3-4 ESCC patients treated with definitive CCRT.

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治疗时间和等待时间对食管癌终期放化疗结果的影响。

目的：探讨治疗时间和等待时间对食管鳞状细胞癌（ESCC）同步放化疗（CCRT）患者临床预后的影响。方法与材料：回顾性分析2008年至2024年西京医院ESCC患者行明确CCRT治疗的病例。根据以下治疗时间和等待时间的单独定义进行分析：(1)理论最小放疗时间（TMRT）；(2)总治疗时间（OTT）；(3)超过时间（ET）；(4)放疗起始时间（TSR）；(5)总等待时间（OWT）。使用Cox回归分析研究治疗时间、等待时间和生存结果之间的关系。结果：共研究541例患者，治疗时间延长、等待时间延长的现象较为普遍。总体而言，TMRT、OTT、ET、TSR和OWT的中位数分别为38天（四分位间距（IQR）： 38-40天）、43天（IQR: 40-47天）、4天（IQR: 2-7天）、88天（IQR: 62-126天）和21天（IQR: 14-31天）。多因素分析显示，延迟治疗时间和等待时间对总生存期（OS）、局部无复发生存期（LRFS）、远端无转移生存期（DMFS）和无进展生存期（PFS）均无影响（p < 0.05）。结论：延迟治疗时间和等待时间对OS、LRFS、DMFS和PFS无影响。然而，较长的TSR被发现与T1-2期而不是T3-4期ESCC患者的生存结果降低相关。

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

Radiation Oncology ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

6.50

自引率

2.80%

发文量

181

审稿时长

3-6 weeks

期刊介绍： Radiation Oncology encompasses all aspects of research that impacts on the treatment of cancer using radiation. It publishes findings in molecular and cellular radiation biology, radiation physics, radiation technology, and clinical oncology.