1034 - Total Radiotherapy Treatment Time in Head and Neck Cancer Patients Treated with IGRT in a Latin American Middle-Income Country
Presenter(s)
P. N. Copeland1, D. K. Dietrich1, E. Pulido2, A. C. Aya2, H. Trujillo2, N. Sanchez2, A. Cardona2, J. S. M. Villalobos2, A. P. Rodríguez3, O. I. Olopade4, A. Juloori5, I. Bobadilla3, and A. Gonzalez3; 1University of Chicago Pritzker School of Medicine, Chicago, IL, 2GIGA Research Group, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center – CTIC, Bogotá, Colombia, 3Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center – CTIC, Bogotá, Colombia, 4Division of Hematology Oncology, University of Chicago Medical Center, Chicago, IL, 5Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL
Purpose/Objective(s): Head and neck squamous cell carcinoma (HNSCC) is expected to pose an increasingly significant healthcare burden in Colombia where cancer incidence is estimated to increase by 86.5% from 2018 to 2040. In Colombia, a middle-income country in Latin America (LATAM), there is a severe shortage of radiation oncologists, machinery, and support staff for radiotherapy (RT), which may contribute to RT delays. Delays in initiating RT and prolonged radiotherapy treatment times (RTT) are linked to lower local control, higher recurrence rates, and worse overall survival in HNSCC patients. Despite the importance of timely RT, we found no studies investigating the RTT and delays for HNSCC in all of LATAM. This study addresses this gap by evaluating the duration of RT, delays in RT initiation, and the factors contributing to prolonged RTT among HNSCC patients treated with image-guided daily radiotherapy (IGRT) in Colombia.
Materials/Methods: This retrospective study included HNSCC patients who received IGRT from October 2022 to December 2024 at a cancer institution in Bogotá, Colombia. Univariate and multivariate analyses were performed with a logistic regression to identify risk factors for prolonged RTT. Multivariate linear regressions identified factors associated with increased RTT. Following literature, prolonged RTT was defined as >56 days for definitive RT and >49 days for adjuvant RT.
Results: The cohort included 62 patients; 24 had definitive RT and 38 had adjuvant RT. The mean (SD) RTT for the cohort was 51 days (9). The mean (SD) RTT for patients receiving definitive radiation and adjuvant radiation was 49 (6) and 52 (11), respectively. Overall, 33.9% of patients experienced prolonged RTT. 8.3% of definitive patients and 50% of adjuvant patients had prolonged RTT. The median time from biopsy to the start of RT was 68 days; the median time from surgery to RT initiation was 61 days. Multivariate linear regression showed an association between increased RTT and both concomitant chemotherapy (p=0.023, coefficient=9.42) and adjuvant RT (p=0.000, coefficient=5.26). Prolonged RTT was associated with adjuvant RT (p=0.003, OR=12.6) in multivariate analysis and subsidized insurance (p=0.042, OR=6.09) in univariate analysis.
Conclusion: This is the first study to characterize the mean duration of RTT and the time spent in different phases of care for HNSCC patients undergoing daily IGRT in a middle-income country in LATAM. The overall mean RTT was within a duration associated with favorable oncologic outcomes for definitive patients. However, adjuvant patients faced a higher risk of prolonged RTT. Subsidized insurance may also increase the risk for prolonged RTT. Receiving concomitant chemotherapy was associated with a longer RTT. Other phases of care—biopsy to RT and surgery to RT—also had delays that may worsen clinical outcomes. Our findings highlight the need for targeted interventions to reduce treatment delays, particularly in the adjuvant setting, to improve RT outcomes in HNSCC patients.