title: The impact of overall radiotherapy treatment time and delay in initiation of radiotherapy on local control and distant metastases in gastric cancer.
abstract: OBJECTIVE
  To study the impact of time factors on local and distant metastases in stomach cancer.
  
  
  METHODS
  67 patients with gastric cancer who received adjuvant treatment were reviewed for the time to initiation of radiotherapy, overall duration of RT and the events of first local recurrence or distant metastasis.
  
  
  RESULTS
  The risk probability of local recurrence is increased by 10% (HR=1.1, p=0.0009) in association with each additional day of radiotherapy and by 3.8% (HR=1.038, p=0.13) per increased day of waiting time before the initiation of RT. The risk probability of distant recurrence was associated with an increase of 7.4% (HR=1.074 p=0.0031) with each additional day of RT time and by 2.3% (HR=1.023, p=0.0598) following the increase of a day of waiting time. Each day of prolongation of RT beyond 36 days was associated with an increased risk of local recurrence by 10% (OR=1.1, p=0.015). Prolongation of waiting time prior to initiation of irradiation retained significance in multivariate analysis.
  
  
  CONCLUSIONS
  There is an association between total treatment time and, to some extent, the time between the surgery and the initiation of radiation on local control and distant metastases.
authors.affiliation: Tel Aviv University, 6 Weizman street, 64239 Tel Aviv, Israel. slavas2506@yahoo.com.
authors.forename: Viacheslav
authors.initials: V
authors.lastname: Soyfer
authors.forename: Ravit
authors.initials: R
authors.lastname: Geva
authors.forename: Michael
authors.initials: M
authors.lastname: Michelson
authors.forename: Moshe
authors.initials: M
authors.lastname: Inbar
authors.forename: Einat
authors.initials: E
authors.lastname: Shacham-Shmueli
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Corn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000532:radiotherapy*; D061665:Time-to-Treatment / Q000706:statistics & numerical data; D055815:Young Adult