DOES WAITING TIME AFFECT THE OUTCOME OF LARYNX CANCER TREATED BY RADIOTHERAPY

Aim: To determine the impact of waiting for radiotherapy on local cont rol in early larynx cancer treated by radiotherapy alone. Methods: Rec ords of patients with T1 and T2, NO-2 larynx cancer were examined at t hree radiotherapy centres, Waiting time was defined in three ways, (1) time from biopsy to radiotherapy, (2) time from presentation to radia tion department to start of radiotherapy and (3) the minimum of (1) an d (2), Time to relapse was the major end point. Results: There were 58 1 patients with a median follow-up of 6.8 years. Stage distribution wa s as follows: T1, 370; T2a, 106; T2b, 94; T2 unspecified, 11; N0, 563; N+, 18. Median times from biopsy, presentation and minimum time to tr eatment were 24, 16 and 15 days, respectively. Ninety percent of minim um waiting times were less than or equal to 31 days. The median dose w as 61 Gy in a median of 30 fractions over a median 46 days. Local recu rrence occurred in 126 patients. The actuarial recurrence free rate at 5 years was 77% (SE 2%). In a multivariate analysis the significant p redictors of relapse were higher T stage, longer treatment duration an d increasing field area. Waiting time was not significantly associated with local relapse. Conclusion: This study did not show longer waitin g time to be a significant predictor of relapse in early larynx cancer . Other end-points which are relevant, such as quality of life, have n ot been examined. Longer treatment times were significantly associated with relapse. (C) 1997 Elsevier Science Ireland Ltd.