Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
Department of Radiotherapy and Radiation Oncology, Jena University Hospital, Jena, Germany.
Eur Arch Otorhinolaryngol. 2022 Sep;279(9):4549-4560. doi: 10.1007/s00405-022-07392-w. Epub 2022 Apr 30.
This retrospective study investigated factors influencing time to treatment initiation (TTI) and the influence of TTI on overall survival (OS) of primary head and neck cancer (HNC) patients in cohorts from 2003, 2008 and 2013.
Two hundred and ninenty seven patients (78.8% men; median age: 62 years) were included. Kaplan-Meier analyses and multivariate Cox regression were performed to investigate OS.
Mean times to treatment initiation (TTI) of 2003, 2008 and 2013 were 17.11 ± 18.00, 30.26 ± 30.08 and 17.30 ± 37.04 days, respectively. TTI for patients with T3/T4 tumors was higher than for T1/T2 (p = 0.010). In univariable analysis on OS, TTI > 5 days showed lower OS (p = 0.047). In multivariate analysis, longer TTI had no influence on lower OS [hazard ratio (HR) 1.236; 95% CI 0.852-1.791; p = 0.264], but male gender [HR 2.342; 95% CI 1.229-4.466; p = 0.010], increased age [HR 1.026; 95% CI 1.008-1.045; p = 0.005], M1 [HR 5.823; 95% CI 2.252-15.058; p = 0.003], hypopharynx tumor [HR 2.508; 95% CI 1.571-4.003; p < 0.001] and oral cavity tumor [HR 1.712; CI 1.101-2.661; p = 0.017]. The year of treatment showed no significant effect on OS.
Median TTI seemed to be very short compared to other studies. There was no clear trend in the impact of TTI on OS from 2003 to 2013.
本回顾性研究调查了影响原发性头颈部癌症（HNC）患者治疗开始时间（TTI）的因素，以及 TTI 对患者总生存（OS）的影响，研究对象来自 2003 年、2008 年和 2013 年的队列。
共纳入 297 例患者（78.8%为男性；中位年龄：62 岁）。采用 Kaplan-Meier 分析和多变量 Cox 回归分析来研究 OS。
2003 年、2008 年和 2013 年的平均 TTI 分别为 17.11±18.00、30.26±30.08 和 17.30±37.04 天。T3/T4 肿瘤患者的 TTI 高于 T1/T2 患者（p=0.010）。在 OS 的单变量分析中，TTI＞5 天的患者 OS 较低（p=0.047）。在多变量分析中，较长的 TTI 对较低的 OS 没有影响[风险比（HR）1.236；95%CI 0.852-1.791；p=0.264]，但男性[HR 2.342；95%CI 1.229-4.466；p=0.010]、高龄[HR 1.026；95%CI 1.008-1.045；p=0.005]、M1 期[HR 5.823；95%CI 2.252-15.058；p=0.003]、下咽肿瘤[HR 2.508；95%CI 1.571-4.003；p＜0.001]和口腔肿瘤[HR 1.712；CI 1.101-2.661；p=0.017]患者的 OS 较低。治疗年份对 OS 无显著影响。
与其他研究相比，中位 TTI 似乎非常短。2003 年至 2013 年，TTI 对 OS 的影响没有明显的趋势。
