Review of time to treatment for head and neck cancer patients at a rural Maine cancer center.

Abstract

292 Background: Time to Treatment (TTT) for head and neck (H&N) malignancies were reviewed for all patients treated at Northern Light Cancer Institute, from 2013 to 2017. A total of 297 cases were identified. Methods: TTT was defined as time of tissue diagnosis by biopsy to the first treatment day. Data was compared to a comprehensive study of 51,655 cases conducted by Murphy et al (JCO, 34; 2, Jan 10, 2016). Median days to treatment were compared by tumor site and treatment modality. Comparison of the distribution of cases where TTT exceeded the critical time point of 67 days (determined by Murphy) was also made. The primary mode of treatment was a combination of chemotherapy and radiation (concomitant) in 39.5% of patients. Other treatment modalities included radiation only (17.2%), and surgery, either as stand-alone treatment, or followed by subsequent additional treatment (32.4%). These treatment modalities comprise 89.1% of all cases. Results: We identified 82 (27.7%) patients with oral cancer, 99 (33.5%) with oropharyngeal malignancy and 92 (31.1%) with laryngeal cancer. Median TTT was 40 days (compared to 34 days found by Murphy) for chemo-radiation patients, 42 (versus 31) for radiation only, and 34 (versus 17) for surgery. TTT for surgery patients was significantly shorter than the other two treatment modalities (p < 0.05). There were no significant differences in TTT based on primary site. All comparisons to Murphy (treatment and primary site) were significantly lower than our median values (p < 0.05). Median TTT over 5 years maintained the same relationship between the treatment modalities. 29.2% of our patients were treated within 30 days, 50% from 31-52 days, 10.6% from 53-67 days, and 10.2% beyond 67 days, compared with 59.5, 23.3, 8.3, and 9% respectively found by Murphy. Conclusions: TTT for H&N cancers has been relatively stable over the 5-year time course examined. The majority of our patients (50%) are treated in the 31-52 day timeframe compared with the first 30 days (59.5%) with Murphy. Our data suggest similar percentages (10.2 versus 9%) after which patients had poorer outcome. Further efforts should be entertained to make sure patients are seen sooner in the oncology clinic.