{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:57:54Z","timestamp":1790686674085,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the impact of diagnosis\u2010to\u2010treatment interval (DTI) and radiotherapy interval (RTI) on overall survival (OS) in locally advanced nasopharyngeal carcinoma (LA\u2010NPC) treated with concurrent chemoradiotherapy (CCRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective database study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings<\/jats:title>\n                    <jats:p>Single tertiary academic center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 285 LA\u2010NPC patients treated with CCRT between 2010 and 2024. Receiver operating characteristic (ROC) analysis was used to derive optimal thresholds for DTI and RTI. OS was estimated using the Kaplan\u2010Meier method and compared with log\u2010rank tests. Multivariable Cox models assessed independent associations, with hazard ratios (HRs) reported with 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After a median follow\u2010up of 75.6 months, median OS was 108 months. ROC\u2010derived thresholds of 30 days for DTI and 49 days for RTI were applied. DTI\u2009\u2264\u200930 days was associated with improved OS compared with &gt;30 days (not reached vs 64.0 months;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), as was RTI\u2009\u2264\u200949 versus &gt;49 days (122.0 vs 74.0 months;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). On multivariable analysis, DTI\u2009&gt;\u200930 days (HR: 2.56, 95% CI: [2.11\u20103.82],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and RTI\u2009&gt;\u200949 days (HR: 1.65, 95% CI: 1.09\u20102.47,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.002) were independently associated with inferior OS. Patients with both delays had the poorest survival (median OS: 51.0 months). DTI\u2009&gt;\u200930 days was associated with increased distant metastasis, whereas RTI\u2009&gt;\u200949 days was associated with higher locoregional failure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DTI\u2009&gt;\u200930 days and RTI\u2009&gt;\u200949 days are independently associated with worse survival in LA\u2010NPC treated with definitive CCRT. These findings support timely treatment initiation and uninterrupted radiotherapy delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70467","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:18:26Z","timestamp":1790684306000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Individual and Cumulative Impacts of Diagnosis\u2010to\u2010Treatment Interval and Radiotherapy Interval on Survival in Nasopharyngeal Cancer"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8120-7123","authenticated-orcid":false,"given":"Erkan","family":"Topkan","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine Baskent University Adana Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8251-6913","authenticated-orcid":false,"given":"Efsun","family":"Somay","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Baskent University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibel","family":"Bascil","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dentistry Baskent University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duriye","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Afyonkarahisar Health and Science University Afyonkarahisar Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8087-3140","authenticated-orcid":false,"given":"Ugur","family":"Selek","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine Koc University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/16-180"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2021.720418","article-title":"Outcomes of recurrent nasopharyngeal carcinoma patients treated with salvage surgery: a meta\u2010analysis","volume":"11","author":"Feng Y","year":"2021","journal-title":"Front Oncol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2012.03.008"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2005.06.037"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.60.9347"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.06.158"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.08.149"},{"issue":"5","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","DOI":"10.1056\/EVIDoa2400214","article-title":"Induction versus concurrent chemotherapy for advanced nasopharyngeal carcinoma","volume":"4","author":"Huang PY","year":"2025","journal-title":"NEJM Evid"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.4.1310"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66698-6"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12253-015-9913-z"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2021.703995","article-title":"Prognostic factors for overall survival in nasopharyngeal cancer and implication for TNM staging by UICC: a systematic review of the literature","volume":"11","author":"Chiang CL","year":"2021","journal-title":"Front Oncol"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2024.1385479","article-title":"Inflammation and cancer: friend or foe","volume":"15","author":"Turizo\u2010Smith AD","year":"2024","journal-title":"Front Pharmacol"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.610303"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S320145"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2022.06.001"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2020.104819"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.7789"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/28.3.207"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(97)00339-8"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-018-4495-2"},{"key":"e_1_2_10_23_1","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2021.648637","article-title":"The effect of prolonged duration of intensity modulated radiotherapy for nasopharyngeal carcinoma","volume":"11","author":"Hua YJ","year":"2021","journal-title":"Front Oncol"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0141332"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0151899"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1724600818821688"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2019.07.007"},{"issue":"49","key":"e_1_2_10_28_1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000031187","article-title":"Efficacy and toxicity of three concurrent chemoradiotherapy regimens in treating nasopharyngeal carcinoma: comparison among cisplatin, nedaplatin, and lobaplatin","volume":"101","author":"Liang X","year":"2022","journal-title":"Medicine"},{"issue":"1","key":"e_1_2_10_29_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-69811-8","article-title":"Optimizing the cumulative cisplatin dose for concurrent chemoradiotherapy beneficiaries among elderly nasopharyngeal carcinoma patients: a real world study","volume":"14","author":"Wu YL","year":"2024","journal-title":"Sci Rep"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.108.057307"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.14639\/0392-100X-N2223"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.12.009"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.currproblcancer.2024.101060"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27011"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2021.105506"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2010.04.006"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/jrr\/rrab008"},{"issue":"1115","key":"e_1_2_10_38_1","doi-asserted-by":"crossref","DOI":"10.1259\/bjr.20200125","article-title":"Dose compensation based on biological effectiveness due to interruption time for photon radiation therapy","volume":"93","author":"Kawahara D","year":"2020","journal-title":"Br J Radiol"},{"key":"e_1_2_10_39_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.radphyschem.2022.110214","article-title":"Radiotherapy treatment interruptions during the Covid\u201019 pandemic: the UK experience and implications for radiobiology training","volume":"200","author":"Dale RG","year":"2022","journal-title":"Radiat Phys Chem"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.3109\/02841868809090333"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25789"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(90)90357-P"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1053\/ejso.1999.0907"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.770"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2023.106652"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28592"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctro.2023.100668"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70467","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70467","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70467","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:18:29Z","timestamp":1790684309000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":46,"alternative-id":["10.1002\/ohn.70467"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70467","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"2025-08-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ohn.70467"}}