title: Radical radiotherapy for cervix cancer: the effect of waiting time on outcome.
abstract: OBJECTIVE
  To assess the effect of treatment waiting time on clinical outcome for patients with cervix cancers treated with radical radiotherapy.
  
  
  METHODS
  A retrospective analysis was conducted on all cervix cancer patients treated with radical radiotherapy between 1990 and 2001 at the Ottawa Regional Cancer Centre. Analyses were performed according to the three following separate definitions of waiting times: interval from start of radiotherapy to (1) date of initial biopsy, (2) date of examination under anesthesia, and (3) date of radiation oncology consultation. Associations between waiting times and patient characteristics and disease control were investigated using t-tests, analyses of variance, and Cox regression analyses.
  
  
  RESULTS
  A total of 195 patients were studied. The vast majority of patients were treated within 5, 6, and 8 weeks of their consultation (91%), examination under anesthesia (88%), and biopsy (81%), respectively. On average, delays between initial biopsy and treatment start were greater for older patients (p = 0.025) (5.8 weeks for <40 years old vs. 6.6 weeks for >70 years old) and those with smaller tumors (p < 0.001) (5.0 weeks for >4 cm vs. 6.3 weeks for < or =4 cm). Univariate analysis revealed no adverse effect of treatment delay on tumor control. Multivariate analysis, with the inclusion of multiple prognostic tumor and treatment parameters, revealed an adverse effect of treatment delay on survival outcomes.
  
  
  CONCLUSIONS
  Longer radiotherapy waiting times were found to be associated with diminished survival outcomes for patients treated radically for cervix cancer. The significance of this observed association requires further investigation.
authors.affiliation: Department of Radiation Oncology, The Ottawa Hospital Regional Cancer Centre, 503 Smyth Road, Ottawa, ON K1H-1C4, Canada. ce@ottawahospital.on.ca
authors.forename: Choan
authors.initials: C
authors.lastname: E
authors.forename: Simone
authors.initials: S
authors.lastname: Dahrouge
authors.forename: Rajiv
authors.initials: R
authors.lastname: Samant
authors.forename: Ameneh
authors.initials: A
authors.lastname: Mirzaei
authors.forename: Julie
authors.initials: J
authors.lastname: Price
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D005500:Follow-Up Studies; D006441:Hemoglobin A / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000532:radiotherapy*
chemical_list: D006441:Hemoglobin A