Chen Po-Chun, Yang Ching-Chieh, Wu Cheng-Jung, Liu Wen-Shan, Huang Wei-Lun, Lee Ching-Chih
Department of Radiation Oncology, Pingtung Christian Hospital, Pingtung, Taiwan.
Department of Radiation Oncology, Chi-Mei Medical Center, Tainan, Taiwan.
PLoS One. 2014 Oct 14;9(10):e109930. doi: 10.1371/journal.pone.0109930. eCollection 2014.
Radiotherapy with or without chemotherapy is the primary treatment for patients with nasopharyngeal carcinoma (NPC). It wastes time from diagnosis to treatment. Treatment time of radiotherapy generally takes at least seven weeks. The current study aimed to evaluate factors associated with prolonged wait time and longer duration of radiotherapy in NPC patients.
From Taiwan's National Health Insurance research database, we identified 3,605 NPC patients treated with radiotherapy between 2008 and 2011. Wait time was calculated from the date of diagnosis to the start of radiotherapy. The impact of each variable on wait time and duration of radiotherapy was examined by multilevel analysis using a random-intercept model.
The mean wait time and duration of radiotherapy were 1.78±3.33 and 9.72±7.27 weeks, respectively. Multilevel analysis revealed prolonged wait time in patients aged 45-65 years, those receiving radiotherapy alone, those with more comorbidities, those with low SES, and those living in eastern Taiwan. A prolonged duration of radiotherapy was associated with receipt of concurrent chemoradiotherapy, more comorbidities, and moderate SES.
Understanding the factors associated with longer wait times and duration of radiotherapy in patients with NPC may help healthcare providers better assist both these patients and potentially those with other head-and-neck cancers.
放疗联合或不联合化疗是鼻咽癌（NPC）患者的主要治疗方法。从诊断到治疗会浪费时间。放疗的治疗时间通常至少需要七周。本研究旨在评估与NPC患者等待时间延长和放疗持续时间延长相关的因素。
从台湾国民健康保险研究数据库中，我们确定了2008年至2011年间接受放疗的3605例NPC患者。等待时间从诊断日期计算至放疗开始日期。使用随机截距模型通过多水平分析检查每个变量对等待时间和放疗持续时间的影响。
放疗的平均等待时间和持续时间分别为1.78±3.33周和9.72±7.27周。多水平分析显示，年龄在45 - 65岁的患者、仅接受放疗的患者、合并症较多的患者、社会经济地位较低的患者以及居住在台湾东部的患者等待时间延长。放疗持续时间延长与接受同步放化疗、合并症较多以及中等社会经济地位相关。
了解与NPC患者等待时间延长和放疗持续时间延长相关的因素，可能有助于医疗服务提供者更好地帮助这些患者以及潜在的其他头颈癌患者。
