Chronotherapy in head and neck cancer: A systematic review and meta‐analysis
2025

Chronotherapy in Head and Neck Cancer: A Review

Sample size: 3366 publication 10 minutes Evidence: moderate

Author Information

Author(s): Abusamak Mohammad, Abu‐Samak Abdel‐Azez, Cai Wenji, Al‐Waeli Haider, Al‐Hamed Faez Saleh, Al‐Tamimi Mohammad, Juweid Malik, Chaurasia Akhilanand, Nicolau Belinda, Tamimi Faleh

Primary Institution: Faculty of Dental Medicine and Oral Health Sciences McGill University

Hypothesis

Does chronotherapy improve treatment efficacy and reduce toxicity in head and neck cancer patients?

Conclusion

Chrono-chemotherapy shows improved treatment efficacy, while chrono-radiotherapy maintains efficacy and reduces toxicity.

Supporting Evidence

  • HNC patients who underwent chrono-radiotherapy had 31% less risk of developing severe oral mucositis compared to evening radiotherapy.
  • HNC patients who underwent chrono-chemotherapy had 73% less risk of lower objective response rate compared to nontime-stipulated chemotherapy.
  • HNC patients who underwent chrono-chemotherapy had 41% less risk of overall toxicity and adverse events compared to nontime-stipulated chemotherapy.

Takeaway

This study looks at how timing cancer treatments can help patients feel better and get better results. It found that giving treatments at certain times can reduce side effects and improve how well they work.

Methodology

A systematic review and meta-analysis of 22 studies evaluating chrono-radiotherapy and chrono-chemotherapy in head and neck cancer patients.

Potential Biases

High risk of bias due to lack of blinding in treatment assignment and outcome assessment.

Limitations

The studies included varied in design, and many had high risk of bias due to lack of blinding.

Participant Demographics

Majority were males aged 35-65 with head and neck squamous cell carcinomas.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CI: 0.09–0.84

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1002/ijc.35234

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