title: Timely initiation of chemotherapy: a systematic literature review of six priority cancers - results and recommendations for clinical practice.
abstract: This review evaluated the association between time-to-chemotherapy (TTC) and survival in six priority cancers. A systematic review of the literature was undertaken for papers indexed in the MEDLINE and Cochrane Library databases from the earliest index until April 2014. The methodology used has been published in a separate paper (Guidelines for timely initiation of chemotherapy: a proposed framework for access to medical oncology and haematology cancer clinics and chemotherapy services). The optimal timing of chemotherapy in breast cancer is unclear as available studies are of low quality, report inconsistent results and are limited to the adjuvant setting. However, increased TTC may have a negative prognostic impact, and delays beyond 4 weeks should be avoided. Studies suggest that the optimal timing for initiation of adjuvant chemotherapy for surgically resected colorectal cancer is 4-8 weeks post-surgery. Timing of chemotherapy for metastatic colorectal cancer does not influence survival. There is a paucity of studies to guide the timing of chemotherapy for the treatment of lymphoma and myeloma; no definitive conclusions can be drawn, and clinician discretion should be applied. The optimal timing of chemotherapy in lung cancer is unclear; however, rapid tumour growth and poor disease prognosis suggest that delays should be avoided wherever possible. The optimal timing of chemotherapy in ovarian cancer is unclear as available studies are of low level, report inconsistent results and are limited to the post-surgery setting; however, increased TTC may have a negative prognostic impact; therefore, delays beyond 4 weeks should be avoided.
authors.affiliation: Department of Pharmacy, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Alexander
authors.affiliation: Department of Medical Oncology, Bendigo Health, Bendigo, Victoria, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Blum
authors.affiliation: Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Burbury
authors.affiliation: Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia.|Department of Centre for Medicine Use and Safety, Monash University, Melbourne, Victoria, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Coutsouvelis
authors.affiliation: Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia.|Department of Centre for Medicine Use and Safety, Monash University, Melbourne, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Dooley
authors.affiliation: Pharmacy Department, Monash Health, Melbourne, Victoria, Australia.
authors.forename: O
authors.initials: O
authors.lastname: Fazil
authors.affiliation: Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Victoria, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Griffiths
authors.affiliation: Departments of Pharmacy, Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Ismail
authors.affiliation: Department of Medical Oncology, Latrobe Regional Hospital, Traralgon, Victoria, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Joshi
authors.affiliation: Department of Nursing, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Love
authors.affiliation: Department of Clinical Haematology, Monash Health, Melbourne, Victoria, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Opat
authors.affiliation: Department of Medical Oncology, Eastern Health, Melbourne, Victoria, Australia.|Department of Eastern Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Parente
authors.affiliation: Department of Clinical Haematology, Monash Health, Melbourne, Victoria, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Porter
authors.affiliation: Division of Neurosciences, Cancer and Infection Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Ross
authors.affiliation: Pharmacy Department, Austin Health, Melbourne, Victoria, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Siderov
authors.affiliation: Departments of Nursing, Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Thomas
authors.affiliation: Department of Medical Oncology, Northern Hospital, Melbourne, Victoria, Australia.
authors.forename: S
authors.initials: S
authors.lastname: White
authors.affiliation: Department of Pharmacy, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Kirsa
authors.affiliation: Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Rischin
mesh_terms: D017024:Chemotherapy, Adjuvant; D006801:Humans; D009369:Neoplasms / Q000145:classification / Q000188:drug therapy*; D019984:Quality Indicators, Health Care; D016032:Randomized Controlled Trials as Topic; D061665:Time-to-Treatment
keywords: cancer; chemotherapy; drug therapy; quality indicator; timely