Ungvari Zoltan, Fekete Mónika, Buda Annamaria, Lehoczki Andrea, Fekete János Tibor, Munkácsy Gyöngyi, Varga Péter, Ungvari Anna, Győrffy Balázs
Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA.
Geroscience. 2025 May 7. doi: 10.1007/s11357-025-01684-9.
Timely initiation of treatment is a core principle of oncologic care, especially for aggressive cancers such as lung cancer. However, the real-world impact of short-term delays in treatment initiation on survival outcomes in lung cancer remains unclear. This meta-analysis evaluates the association between treatment delays of 4, 8, and 12 weeks and all-cause mortality in lung cancer patients. A systematic search was conducted in PubMed, Scopus, and Web of Science for studies published between 2000 and 2025. Of 5360 screened records, 15 studies were included, comprising 16 cohorts for overall survival of lung cancer patients. Hazard ratios (HRs) for 4-, 8-, and 12-week treatment delays were estimated using random-effects meta-analyses. Heterogeneity was measured with the I statistic, and publication bias was assessed using funnel plots and Egger's test. No significant association was found between treatment delay and survival at any of the time points. Pooled HRs were 1.00 (95% CI, 0.99-1.02) for a 4-week delay, 1.01 (95% CI, 0.99-1.03) for an 8-week delay, and 1.01 (95% CI, 0.98-1.05) for a 12-week delay. Despite high heterogeneity (I = 97%), no evidence of publication bias was detected. This meta-analysis found no significant impact of short-term treatment delays (up to 12 weeks) on mortality in lung cancer patients. These findings challenge the assumption that brief delays universally worsen outcomes and underscore the importance of individualized treatment planning and prioritization.
及时开始治疗是肿瘤护理的核心原则，对于肺癌等侵袭性癌症尤为如此。然而，肺癌患者开始治疗的短期延迟对生存结果的实际影响仍不明确。这项荟萃分析评估了4周、8周和12周的治疗延迟与肺癌患者全因死亡率之间的关联。在PubMed、Scopus和Web of Science中进行了系统检索，以查找2000年至2025年发表的研究。在筛选的5360条记录中，纳入了15项研究，包括16个肺癌患者总生存队列。使用随机效应荟萃分析估计4周、8周和12周治疗延迟的风险比（HR）。用I统计量测量异质性，并使用漏斗图和Egger检验评估发表偏倚。在任何时间点均未发现治疗延迟与生存之间存在显著关联。4周延迟的合并HR为1.00（95%CI，0.99 - 1.02），8周延迟的合并HR为1.01（95%CI，0.99 - 1.03），12周延迟的合并HR为1.01（95%CI，0.98 - 1.05）。尽管异质性较高（I = 97%），但未检测到发表偏倚的证据。这项荟萃分析发现，短期治疗延迟（长达12周）对肺癌患者的死亡率没有显著影响。这些发现挑战了普遍认为短暂延迟会普遍恶化预后的假设，并强调了个体化治疗计划和优先级的重要性。
