TY - JOUR
T1 - Importance of the treatment package time in surgery and postoperative radiation therapy for squamous carcinoma of the head and neck
AU - Rosenthal, David I.
AU - Liu, Li
AU - Lee, Jason H.
AU - Vapiwala, Neha
AU - Chalian, Ara A.
AU - Weinstein, Gregory S.
AU - Chilian, Irina
AU - Weber, Randal S.
AU - Machtay, Mitchell
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2002
Y1 - 2002
N2 - Background. To determine the effect of treatment time-related factors on outcome in patients treated with surgery and postoperative radiation therapy (RT) for locally advanced squamous cell carcinoma of head and neck (SCCHN). Methods. A retrospective review was performed on 208 consecutive patients treated from 1992 to 1997 with surgery and postoperative RT (≥55 Gy) for SCCHN. The treatment time factors considered were (1) interval from surgery to the start of RT; (2) RT duration; and (3) the total time from surgery to completion of RT (treatment package time). Treatment package time was dichotomized into short (≤100 days) vs long (>100 days) categories. Other variables considered were clinical and pathologic staging, margin status, RT dose, and tumor site. Patients were also divided into intermediate- and high-risk groups on the basis of eligibility for RTOG 95-01. Univariate (logrank) and multivariate analyses were performed. Results. Median follow-up for surviving patients was 24 months. Actuarial 2-year locoregional control (LRC) and survival rates were 82% and 71%, respectively. In univariate analysis, factors associated with higher locoregional failure were high-risk group (p = .011), margin status (p = .038), pathologic stage (p = .035), clinical N stage (p = .006), package time (p = .013), and RT treatment time (p = .03). Package time was also a significant predictor of survival in univariate analysis (p = .021). The other two individual time factors, tumor factors, and RT dose were not significant. Both risk status and treatment package time were significant factors in a multivariate model of LRC. Conclusions. A total treatment package time of <100 days is associated with improved tumor control and survival. Every effort should be made to keep the time from surgery to the completion of postoperative RT to <100 days.
AB - Background. To determine the effect of treatment time-related factors on outcome in patients treated with surgery and postoperative radiation therapy (RT) for locally advanced squamous cell carcinoma of head and neck (SCCHN). Methods. A retrospective review was performed on 208 consecutive patients treated from 1992 to 1997 with surgery and postoperative RT (≥55 Gy) for SCCHN. The treatment time factors considered were (1) interval from surgery to the start of RT; (2) RT duration; and (3) the total time from surgery to completion of RT (treatment package time). Treatment package time was dichotomized into short (≤100 days) vs long (>100 days) categories. Other variables considered were clinical and pathologic staging, margin status, RT dose, and tumor site. Patients were also divided into intermediate- and high-risk groups on the basis of eligibility for RTOG 95-01. Univariate (logrank) and multivariate analyses were performed. Results. Median follow-up for surviving patients was 24 months. Actuarial 2-year locoregional control (LRC) and survival rates were 82% and 71%, respectively. In univariate analysis, factors associated with higher locoregional failure were high-risk group (p = .011), margin status (p = .038), pathologic stage (p = .035), clinical N stage (p = .006), package time (p = .013), and RT treatment time (p = .03). Package time was also a significant predictor of survival in univariate analysis (p = .021). The other two individual time factors, tumor factors, and RT dose were not significant. Both risk status and treatment package time were significant factors in a multivariate model of LRC. Conclusions. A total treatment package time of <100 days is associated with improved tumor control and survival. Every effort should be made to keep the time from surgery to the completion of postoperative RT to <100 days.
UR - http://www.scopus.com/inward/record.url?scp=0036154545&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036154545&partnerID=8YFLogxK
U2 - 10.1002/hed.10038
DO - 10.1002/hed.10038
M3 - Article
C2 - 11891941
AN - SCOPUS:0036154545
VL - 24
SP - 115
EP - 126
JO - Head and Neck Surgery
JF - Head and Neck Surgery
SN - 1043-3074
IS - 2
ER -