Association Between Geographic Location and Radiotherapy Treatment Delay in Head and Neck Squamous Cell Carcinoma: A Retrospective Study

In head and neck squamous cell carcinoma (HNSCC) treatment, extended waiting times for chemoradiotherapy negatively impact survival outcomes. Identifying contributing factors to these delays and strategies to minimize them could improve the prognosis for HNSCC patients. However, the factors affecting treatment delays remain incompletely understood, warranting further investigation. This retrospective study examined the association between patient residence and treatment delay. Medical records of 125 patients with squamous cell carcinoma of the oropharynx, hypopharynx, or larynx, treated with radiotherapy or chemoradiotherapy at the Department of Otolaryngology, Nagasaki University School of Medicine, were analyzed. Treatment delay was defined as the period from the patient's initial medical visit to the start of treatment at our hospital. The relationship between factors, such as patient location and waiting period, was assessed. Uni- and multivariate logistic regression analyses revealed that residing in a remote area was significantly associated with longer treatment delays (OR: 4.41, 95% CI: 1.40-13.91, p = 0.01; adjusted OR: 7.60, 95% CI: 1.93-29.98, p < 0.01). These findings underscore the need for interventions to reduce treatment delays in HNSCC patients from remote areas.