Survival and overall treatment time after postoperative radio( chemo) therapy in patients with head and neck cancer

Background. Generally, overall treatment time for patients with locally advanced head and neck cancer should be as short as reasonably possible. This analysis was undertaken to determine at what overall treatment time additional survival/locoregional control benefits could be achieved compared to a 100-day cutoff. Methods. Clinical impact of overall treatment time was assessed in 272 patients by multivariable Cox regression and Kaplan-Meier analyses using the historical 100-day cutoff and the optimal overall treatment time, determined using recursive partitioning analysis. Survival endpoints were determined for the 100-day and optimal overall treatment times validated using bootstrap resampling. Results. Recursive partitioning determined the optimal overall treatment time as 87 days. In the 87-day multivariable analysis, adverse factors for overall survival (OS) and disease-free survival (DFS) were overall treatment time >= 87 days and extracapsular spread, and overall treatment time and R1 status, respectively. Conclusion. Overall treatment time is important for survival in patients with head and neck cancer. Completing treatment within as short a timeframe as possible may be associated with longer OS and DFS. (C) 2016 Wiley Periodicals, Inc.