Prognostic significance of wait time for radical radiotherapy in locoregionally advanced nasopharyngeal carcinoma

Head Neck. 2022 May;44(5):1182-1191. doi: 10.1002/hed.27011. Epub 2022 Feb 26.

Abstract

Background: The prognostic significance of wait time between definite diagnosis and initial radical radiotherapy is not well established in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) receiving both induction chemotherapy (IC) and concurrent chemoradiotherapy (CCRT).

Methods: From 2010 to 2018, 648 patients with LA-NPC treated with IC followed by CCRT were included.

Results: A total of 172 pairs of patients with LA-NPC were selected by propensity score matching (PSM). Compared to patients with an acceptable wait time (≤75 days), patients with a prolonged wait time (>75 days) had a significant lower 5-year DMFS rate (86.6% vs. 74.1%, p = 0.006). Subgroup analyses indicated that the unfavorable effects of longer waiting times were mainly seen among stage IVa patients.

Conclusions: A prolonged wait time (>75 days) between definite diagnosis and initial radical radiotherapy has negative prognostic effects on patients with LA-NPC receiving IC plus CCRT, particularly those with IVa stage.

Keywords: distant metastasis-free survival; induction chemotherapy; nasopharyngeal carcinoma; radiotherapy; wait time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemoradiotherapy / adverse effects
  • Cisplatin
  • Humans
  • Induction Chemotherapy
  • Nasopharyngeal Carcinoma / drug therapy
  • Nasopharyngeal Carcinoma / radiotherapy
  • Nasopharyngeal Neoplasms* / drug therapy
  • Nasopharyngeal Neoplasms* / radiotherapy
  • Prognosis
  • Waiting Lists*

Substances

  • Cisplatin