Changes from 1992 to 2002 in the pretreatment delay for patients with squamous cell carcinoma of larynx or pharynx: a Danish nationwide survey from DAHANCA
| Autor: | Hanne Primdahl, Lisbeth Juhler Andersen, Jens Overgaard, Lene Weber Vestermark, Elo Andersen, Anni Linnet Nielsen, Marie Overgaard, Merete Ipsen, Christel Lajer, Susanne Larsen, Hanne Sand Hansen, Cai Grau |
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| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Larynx
Adult Male medicine.medical_specialty Time Factors medicine.medical_treatment Denmark Health care medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Laryngeal Neoplasms Aged Chemotherapy business.industry Pharynx Head and neck cancer Pharyngeal Neoplasms Hematology General Medicine Middle Aged medicine.disease Surgery Radiation therapy DAHANCA medicine.anatomical_structure Oncology Positron-Emission Tomography Carcinoma Squamous Cell Female business Tomography X-Ray Computed |
| Zdroj: | Primdahl, H, Nielsen, A L, Larsen, S, Andersen, E, Ipsen, M, Lajer, C, Vestermark, L W, Andersen, L J, Hansen, H S, Overgaard, M, Overgaard, J, Grau, C & DAHANCA 2006, ' Changes from 1992 to 2002 in the pretreatment delay for patients with squamous cell carcinoma of larynx or pharynx: a Danish nationwide survey from DAHANCA ', Acta Oncologica, vol. 45, no. 2, pp. 156-161 . https://doi.org/10.1080/02841860500423948 Primdahl, H, Nielsen, A L, Larsen, S, Andersen, E, Ipsen, M, Lajer, C, Weber Vestermark, L, Andersen, L J, Hansen, H S, Overgaard, M, Overgaard, J & Grau, C 2006, ' Changes from 1992 to 2002 in the pretreatment delay for patients with squamous cell carcinoma of larynx or pharynx : A Danish nationwide survey from DAHANCA ', Acta Oncologica, vol. 45, no. 2, pp. 156-161 . |
| DOI: | 10.1080/02841860500423948 |
| Popis: | In Denmark, a general impression of prolonged pretreatment delay for patients with head and neck cancer led to a nationwide study of time spans from symptom debut over first health care contact to start of treatment. Charts of consecutive new patients with squamous cell carcinoma of the pharynx and larynx, seen at the five Danish oncology centers in January/April 1992 and 2002, respectively, were reviewed. Of the 288 patients identified, definitive treatment was radiotherapy in 264 cases, surgery in one case. Twenty-three patients had neither surgery nor radiotherapy. Total time from first health care contact to start of definitive treatment was significantly longer in 2002 than in 1992 (median 70 versus 50 days, p B /0.001). There was no significantly difference in time used for diagnosis. Time for treatment preparation and planning was 46 days in 2002 versus 31 days in 1992 (pB /0.001). Significantly more diagnostic procedures (CT, MR, US, PET) were done in 2002. In conclusion, this nationwide study showed that waiting time before start of radiotherapy was significantly longer in 2002 compared to 1992. An increasing number of imaging procedures including CT-based dose planning was observed. The prolongation was mainly related to shortage of radiotherapy capacity. The three weeks extra pretreatment delay could theoretically lead to a 10% lower tumor control probability in 2002 compared to 1992. The clinical workup for patients with head and neck cancer is often complex. Since the options for primary treatment include surgery, radiation therapy, chemotherapy or a combination of these, multidisciplinary care over long periods of time is often required. The expression ‘continuum of care’ has been introduced to describe this ‘coordinated activities in health care linked together to achieve the best possible result for the patient’ [1]. A prolonged delay prior to treatment start may cause decrease in the local control rate as well as survival due to tumor growth [2/5]. Radiobiological studies indicate that a 4-week delay of start of |
| Databáze: | OpenAIRE |
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