BOOST: Head and Neck-Integrated Science and Practice (ISP) Session

Purpose/Objective(s): Treatment delay is a significant impediment to effective cancer management and could potentially impact disease progression and survival, especially in Head and Neck Cancer (HNC) patients who are often diagnosed with locally advanced stage disease. The purpose of this study was to determine the impact of patient and tumor characteristics on time-to-treatment (TTT) from diagnosis in HNC patients treated with curative intent radiation therapy (RT).Materials/Methods: From August 2004 to May 2011, 131 non-metastatic and non-recurrent biopsy proven HNC patients completed definitive RT at an urban academic safety net hospital. Patient and tumor factors examined included: race/ethnicity (Black, White, Hispanic, Other), English proficiency (English proficient, EP, Limited English proficient, LEP), marital status (Married, Non-married), insurance coverage (Private/Medicare, Medicaid/Free care), age at diagnosis (years) (median, =50) and AJCC stage (stage I-III versus stage IV). TTT was calculated from date of biopsy to date of first treatment received (surgery, induction chemotherapy/IC, radiotherapy alone/RT or concurrent radiotherapy/CCRT). Analysis of Variance was performed using SAS version 9.1 to determine the drivers of TTT. Data were analyzed using a 0.05 level of significance. Results: The median TTT was 41 days (range 6-249 days). Surgery, IC, RT or CCRT was the first treatment received in 45 (34.4%), 22 (16.8%), 13 (9.9%) and 51 (38.9%) patients, respectively. TTT did not differ by first treatment received (time to surgery 48 days, time to IC 47 days, time to RT 40 days and time to CCRT 51 days), P=0.802. No statistically significant differences in TTT were noted for gender (P=0.637), race/ethnicity (P=0.996), marital status (P=0.737), insurance coverage (P=0.836), age at diagnosis (P=0.571), and AJCC stage (P=0.889). TTT among EP and LEP patients was 46 and 57 days, respectively (P=0.197).Conclusion: Limited English proficient patients had longer TTT compared to EP, although this result failed to reach statistical significance. Other patient and tumor factors were not found to be predictive of TTT. Participants Minoru Nakatsugawa, PhD, Baltimore, MD (Presenter) Employee, Toshiba Corporation; Research support, Toshiba Corporation; Zhi Cheng, MD, MPH, Baltimore, MD (Abstract Co-Author) Research Grant, Toshiba Corporation Scott Robertson, Baltimore, MD (Abstract Co-Author) Nothing to Disclose Kosuke Sakaue, Otawara, Japan (Abstract Co-Author) Employee, Toshiba Corporation Shinya Sugiyama, Otawara, Tochigi, Japan (Abstract Co-Author) Employee, Toshiba Corporation Ana P. Kiess, MD, PhD, Baltimore, MD (Abstract Co-Author) Nothing to Disclose Mysha Allen, RN,BSN, Baltimore, MD (Abstract Co-Author) Nothing to Disclose Sarah Afonso, RN,BSN, Baltimore, MD (Abstract Co-Author) Nothing to Disclose Amanda Choflet, MS,RN, Baltimore, MD (Abstract Co-Author) Nothing to Disclose John Wong, PhD, Baltimore, MD (Abstract Co-Author) Research Grant, Elekta AB; Research Grant, Xstrahl Ltd; Research Grant, Toshiba Corporation; Co-founder, JPLC Associates LLC; Royalty, Elekta AB; Consultant, Xstrahl Ltd Todd R. McNutt, PhD, Baltimore, MD (Abstract Co-Author) Research collaboration, Koninklijke Philips NV; Research collaboration, Toshiba Corporation; Research collaboration, Elekta AB Harry Quon, MD, Baltimore, MD (Abstract Co-Author) Nothing to Disclose