목적: In chemoradiotherapy for head and neck squamous cell carcinoma (HNSCC), longer waiting period for treatment adversely affect survival outcomes. However, factors influencing treatment delays have not yet been completely elucidated, and appropriate responses to such factors suggest further investigation. We conducted a study to clarify factors that lead to delays in the initiation of chemoradiotherapy for HNSCC. In particular, we focused on the residence of patients, taking into account the fact that our hospital's medical area includes many remote islands. 방법:Medical records of patients with squamous cell carcinoma of the oropharynx, hypopharynx, or larynx, who received radiotherapy or chemoradiotherapy at the Department of Otolaryngology, Nagasaki University School of Medicine were analyzed. Cases of recurrence and cases treated at other hospitals were excluded. The primary outcome was the waiting period for treatment. Using the median waiting period as the cutoff value, patients were classified into those with a short waiting period and those with a long waiting period. The association between the waiting period for treatment and factors such as the patient's residence, department of first visit, primary site, stage, receiving welfare benefits, and irradiation method was evaluated. Statistical analysis was performed using JMP Pro 14.2.0, with uni- and multi-variate logistic regression analyses. 결과:164 patients were included. Finally, 125 patients who did not meet the predefined exclusion criteria were included in the analysis. Uni- and multi-variate logistic regression analyses revealed that residing in a remote area was significantly associated with longer treatment delays (adjusted OR: 7.60, 95% CI: 1.9329.98, p < 0.01). In addition, first visit to a non-ENT department was significantly associated with delayed treatment (adjusted OR: 7.27, 95% CI: 2.6020.36, p < 0.01). 결론:In this study, patient's residence and choice of department for first visit were significantly associated with longer waiting period for treatment. It is necessary to devise ways to reduce the impact of these factors on the waiting period for treatment.