Impact of treatment time and waiting time on outcome for esophageal squamous cell carcinoma receiving definitive chemoradiotherapy

Abstract Purpose To assess the effect of treatment time and waiting time on clinical outcome for patients with esophageal squamous cell carcinoma (ESCC) treated with definitive concurrent chemoradiotherapy (CCRT). Methods and materials A retrospective analysis was conducted on ESCC patients treated...

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Main Authors: Geng Xiang, Xiaomeng Wang, Cong Zhang, Guangjin Chai, Bo Lyu, Yutian Yin, Bin Wang, Lina Zhao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Radiation Oncology
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Online Access:https://doi.org/10.1186/s13014-025-02687-8
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author Geng Xiang
Xiaomeng Wang
Cong Zhang
Guangjin Chai
Bo Lyu
Yutian Yin
Bin Wang
Lina Zhao
author_facet Geng Xiang
Xiaomeng Wang
Cong Zhang
Guangjin Chai
Bo Lyu
Yutian Yin
Bin Wang
Lina Zhao
author_sort Geng Xiang
collection DOAJ
description Abstract Purpose To assess the effect of treatment time and waiting time on clinical outcome for patients with esophageal squamous cell carcinoma (ESCC) treated with definitive concurrent chemoradiotherapy (CCRT). Methods and materials A retrospective analysis was conducted on ESCC patients treated with definitive CCRT between 2008 and 2024 at Xijing hospital. Analyses were performed according to the following separate definitions of treatment time and waiting time: (1) theoretical minimal radiotherapy time (TMRT); (2) overall treatment time (OTT); (3) exceeding time (ET); (4) time to start of radiotherapy (TSR); (5) overall waiting time (OWT). Associations between treatment time and waiting time and survival outcome were investigated using Cox regression analyses. Results A total of 541 patients were studied and prolonged treatment time and waiting time were common. Overall, the median TMRT, OTT, ET, TSR, and OWT were 38 days [interquartile range (IQR): 38–40 days], 43 days (IQR: 40–47 days), 4 days (IQR: 2–7 days), 88 days (IQR: 62–126 days), and 21 days (IQR: 14–31 days), respectively. Multivariate analysis revealed that delay of treatment time and waiting time has no effect on overall survival (OS), locoregional relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and progression-free survival (PFS) (all p > 0.05). In the subgroup of patients with T1-2 ESCC disease, the TSR < 72 days group had significantly more favorable OS (p = 0.009), LRFS (p = 0.003), and PFS (p = 0.022) compared with TSR ≥ 72 days group. Conclusions Delay of treatment time and waiting time has no effect on OS, LRFS, DMFS, and PFS. However, longer TSR was found to be associated with diminished survival outcomes for T1-2 stage rather than T3-4 ESCC patients treated with definitive CCRT.
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spelling doaj-art-3eba83bd3a284827a0208a64139e763b2025-08-20T03:46:12ZengBMCRadiation Oncology1748-717X2025-07-0120111010.1186/s13014-025-02687-8Impact of treatment time and waiting time on outcome for esophageal squamous cell carcinoma receiving definitive chemoradiotherapyGeng Xiang0Xiaomeng Wang1Cong Zhang2Guangjin Chai3Bo Lyu4Yutian Yin5Bin Wang6Lina Zhao7Department of Radiation Oncology, Xijing Hospital, Air Force Medical UniversityDepartment of Radiation Oncology, Xijing Hospital, Air Force Medical UniversityDepartment of Radiation Oncology, Xijing Hospital, Air Force Medical UniversityDepartment of Radiation Oncology, Xijing Hospital, Air Force Medical UniversityDepartment of Radiation Oncology, Xijing Hospital, Air Force Medical UniversityDepartment of Radiation Oncology, Xijing Hospital, Air Force Medical UniversityDepartment of Radiation Oncology, Xijing Hospital, Air Force Medical UniversityDepartment of Radiation Oncology, Xijing Hospital, Air Force Medical UniversityAbstract Purpose To assess the effect of treatment time and waiting time on clinical outcome for patients with esophageal squamous cell carcinoma (ESCC) treated with definitive concurrent chemoradiotherapy (CCRT). Methods and materials A retrospective analysis was conducted on ESCC patients treated with definitive CCRT between 2008 and 2024 at Xijing hospital. Analyses were performed according to the following separate definitions of treatment time and waiting time: (1) theoretical minimal radiotherapy time (TMRT); (2) overall treatment time (OTT); (3) exceeding time (ET); (4) time to start of radiotherapy (TSR); (5) overall waiting time (OWT). Associations between treatment time and waiting time and survival outcome were investigated using Cox regression analyses. Results A total of 541 patients were studied and prolonged treatment time and waiting time were common. Overall, the median TMRT, OTT, ET, TSR, and OWT were 38 days [interquartile range (IQR): 38–40 days], 43 days (IQR: 40–47 days), 4 days (IQR: 2–7 days), 88 days (IQR: 62–126 days), and 21 days (IQR: 14–31 days), respectively. Multivariate analysis revealed that delay of treatment time and waiting time has no effect on overall survival (OS), locoregional relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and progression-free survival (PFS) (all p > 0.05). In the subgroup of patients with T1-2 ESCC disease, the TSR < 72 days group had significantly more favorable OS (p = 0.009), LRFS (p = 0.003), and PFS (p = 0.022) compared with TSR ≥ 72 days group. Conclusions Delay of treatment time and waiting time has no effect on OS, LRFS, DMFS, and PFS. However, longer TSR was found to be associated with diminished survival outcomes for T1-2 stage rather than T3-4 ESCC patients treated with definitive CCRT.https://doi.org/10.1186/s13014-025-02687-8Esophageal squamous cell carcinomaChemoradiotherapyTreatment timeWaiting timeOverall survival
spellingShingle Geng Xiang
Xiaomeng Wang
Cong Zhang
Guangjin Chai
Bo Lyu
Yutian Yin
Bin Wang
Lina Zhao
Impact of treatment time and waiting time on outcome for esophageal squamous cell carcinoma receiving definitive chemoradiotherapy
Radiation Oncology
Esophageal squamous cell carcinoma
Chemoradiotherapy
Treatment time
Waiting time
Overall survival
title Impact of treatment time and waiting time on outcome for esophageal squamous cell carcinoma receiving definitive chemoradiotherapy
title_full Impact of treatment time and waiting time on outcome for esophageal squamous cell carcinoma receiving definitive chemoradiotherapy
title_fullStr Impact of treatment time and waiting time on outcome for esophageal squamous cell carcinoma receiving definitive chemoradiotherapy
title_full_unstemmed Impact of treatment time and waiting time on outcome for esophageal squamous cell carcinoma receiving definitive chemoradiotherapy
title_short Impact of treatment time and waiting time on outcome for esophageal squamous cell carcinoma receiving definitive chemoradiotherapy
title_sort impact of treatment time and waiting time on outcome for esophageal squamous cell carcinoma receiving definitive chemoradiotherapy
topic Esophageal squamous cell carcinoma
Chemoradiotherapy
Treatment time
Waiting time
Overall survival
url https://doi.org/10.1186/s13014-025-02687-8
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