Factors associated with radiation treatment delay in head and neck squamous cell carcinoma

Introduction: Head and neck squamous cell carcinomas (HNSCCs) are aggressive tumours lacking a standardised timeline for treatment initiation post-diagnosis. Delays beyond 60 days are linked to poorer outcomes and higher recurrence risk. Methods: A retrospective review was conducted on patients over 18 with HNSCC treated with (chemo) radiation at a rural tertiary care centre (September 2020-2022). Data on patient demographics, oncologic characteristics, treatment details and delay causes were analysed using SPSS. Results: Out of 93 patients, 35.5% experienced treatment initiation delays (TTIs) over 60 days. Median TTI was 73 days for delayed cases, compared to 41.5 days otherwise. No significant differences in demographics or cancer characteristics were observed between groups. The primary reasons for the delay were care coordination (69.7%) and patient factors (18.2%). AJCC cancer stage showed a trend towards longer delays in advanced stages. Conclusion: One-third of patients faced delayed TTI, primarily due to care coordination and lack of social support. These findings highlight the need for improved multidisciplinary communication and patient support mechanisms, suggesting potential areas for quality improvement in HNSCC treatment management.