Fujiwara Rance J T, Judson Benjamin L, Yarbrough Wendell G, Husain Zain, Mehra Saral
Department of Surgery (Otolaryngology), Yale University School of Medicine, New Haven, Connecticut.
Yale Cancer Center, New Haven, Connecticut.
Head Neck. 2017 Apr;39(4):639-646. doi: 10.1002/hed.24608. Epub 2017 Feb 25.
Treatment durations and factors associated with delays for oral cavity squamous cell carcinoma (SCC) have previously been described but are not fully understood. Impact of delays on overall survival (OS) remains unclear.
The National Cancer Data Base (NCDB) was used to analyze 4868 patients with oral cavity SCC from 1998 to 2011. Diagnosis-to-surgery, surgery-to-radiotherapy (RT) , RT duration, total treatment package (surgery-to-RT ), and diagnosis-to-RT were evaluated. Associations between delays and various factors were analyzed using binary logistic regression. Associations with OS were analyzed using the Cox proportional hazards model.
Medians for diagnosis-to-surgery, surgery-to-RT , RT duration, total treatment package, and diagnosis-to-RT were 30, 50, 49, 101, and 136 days, respectively. Age ≥60 years, uninsured or Medicaid insurance, comorbidity, late pT, and treatment at an academic/research institution were associated with diagnosis-to-surgery delays. Only delays in RT duration were significantly associated with decreased OS (hazard ratio [HR] = 1.21; p = .02).
Numerous factors are associated with treatment delays. RT duration is significantly associated with OS. © 2017 Wiley Periodicals, Inc. Head Neck 39: 639-646, 2017.
口腔鳞状细胞癌（SCC）的治疗时长以及与治疗延迟相关的因素此前已有描述，但尚未完全明确。延迟对总生存期（OS）的影响仍不清楚。
利用国家癌症数据库（NCDB）分析了1998年至2011年期间4868例口腔SCC患者。评估了从诊断到手术、从手术到放疗（RT）的时间、放疗时长、整个治疗过程（从手术到放疗）以及从诊断到放疗的时间。使用二元逻辑回归分析延迟与各种因素之间的关联。使用Cox比例风险模型分析与总生存期的关联。
从诊断到手术、从手术到放疗、放疗时长、整个治疗过程以及从诊断到放疗的时间中位数分别为30天、50天、49天、101天和136天。年龄≥60岁、未参保或参加医疗补助保险、合并症、晚期pT以及在学术/研究机构接受治疗与从诊断到手术的延迟有关。只有放疗时长的延迟与总生存期降低显著相关（风险比[HR]=1.21；p=0.02）。
许多因素与治疗延迟有关。放疗时长与总生存期显著相关。©2017威利期刊公司。《头颈》39:639 - 646,2017。
