González Ferreira JA, Fernandez C, Gonsalves D, Paguey I, Couñago F. Radiotherapy treatment time delay evidence, part I: Update on cervical, anal, prostate, and head and neck cancers. World J Clin Oncol 2025; 16(10): 109247 [DOI: 10.5306/wjco.v16.i10.109247]
Corresponding Author of This Article
Jose Antonio González Ferreira, MD, Department of Radiation Oncology, Genesis Care-Spain, Américo Vespucio Street 31-33, Sevilla 41092, Spain. jose.gonzalez@genesiscare.es
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Oncology
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 24, 2025 (publication date) through Oct 27, 2025
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World Journal of Clinical Oncology
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2218-4333
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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González Ferreira JA, Fernandez C, Gonsalves D, Paguey I, Couñago F. Radiotherapy treatment time delay evidence, part I: Update on cervical, anal, prostate, and head and neck cancers. World J Clin Oncol 2025; 16(10): 109247 [DOI: 10.5306/wjco.v16.i10.109247]
World J Clin Oncol. Oct 24, 2025; 16(10): 109247 Published online Oct 24, 2025. doi: 10.5306/wjco.v16.i10.109247
Radiotherapy treatment time delay evidence, part I: Update on cervical, anal, prostate, and head and neck cancers
Jose Antonio González Ferreira, Castalia Fernandez, Daniela Gonsalves, Imanol Paguey, Felipe Couñago
Jose Antonio González Ferreira, Department of Radiation Oncology, Genesis Care-Spain, Sevilla 41092, Spain
Castalia Fernandez, Daniela Gonsalves, Felipe Couñago, Department of Radiation Oncology, Genesis Care-San Francisco de Asís University Hospital, Madrid 28002, Spain
Castalia Fernandez, Daniela Gonsalves, Felipe Couñago, Department of Radiation Oncology, Genesis Care-La Milagrosa University Hospital Madrid, Madrid 28010, Spain
Daniela Gonsalves, Felipe Couñago, Division of Radiation Oncology, Department of Medicine, Faculty of Medicine, Health and Sport Sciences, Universidad Europea de Madrid, Madrid 28670, Spain
Imanol Paguey, Department of Radiation Oncology, Genesis Care-Cordoba, Cordoba 14012, Andalusia, Spain
Author contributions: González Ferreira JA contributed to the conception and design of the study; González Ferreira JA, Fernandez C, Gonsalves D, and Paguey I contributed to the data acquisition; All authors contributed to the analysis and interpretation of the data, contributed to drafting the manuscript, made critical revisions related to important intellectual content, and gave final approval of the version to be published.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jose Antonio González Ferreira, MD, Department of Radiation Oncology, Genesis Care-Spain, Américo Vespucio Street 31-33, Sevilla 41092, Spain. jose.gonzalez@genesiscare.es
Received: May 6, 2025 Revised: June 4, 2025 Accepted: September 5, 2025 Published online: October 24, 2025 Processing time: 172 Days and 19.1 Hours
Abstract
Treatment delays during radiotherapy for head and neck cancer (HNC) are a well-established factor negatively affecting clinical outcomes, with similar trends observed in other cancers. In this first part of a two-part review, we assessed the impact of overall treatment time (OTT) prolongation on locoregional control (LRC) and survival (SV) in cervical cancer (CC), prostate cancer (PC), and anal cancer (AC), while updating evidence for HNC. A comprehensive literature search was performed in evidence-based databases, including MEDLINE, identifying studies evaluating the relationship between OTT prolongation and outcomes. Particular attention was paid to the strength of evidence, distinguishing univariate analysis from multivariate analysis (MV-An). For CC, 37 articles were identified, with 88.8% reporting a detrimental impact on LRC and/or SV, mostly supported by MV-An. In AC, 15 studies were found, with 33.3% showing negative impacts, although with weaker evidence. For PC, 12 articles were reviewed, with 66.6% demonstrating detrimental effects mainly on LRC or biochemical control, and occasional associations with cancer-specific SV. Recent studies in HNC reinforced prior findings. When available, radiobiological parameters and practical recommendations are provided. In conclusion, strong evidence confirms that prolonged OTT worsens outcomes in HNC and CC, with less consistent but relevant effects in PC and AC.
Core Tip: Prolongation of overall treatment time (OTT) during radiotherapy significantly impacts locoregional control and survival outcomes across several tumor types. This mini-review highlights strong evidence supporting the detrimental effect of OTT delays in head and neck and cervical cancers, with moderate evidence for prostate cancer and emerging concern in anal cancer. Recognizing the critical role of maintaining planned treatment schedules, we emphasize the need for proactive management of interruptions and suggest practical recommendations based on current evidence. Early identification and mitigation of treatment delays can substantially improve oncological outcomes across multiple malignancies.
