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Impact of race on outcome after definitive radiotherapy for squamous cell carcinoma of the head and neck
Version of Record online: 22 OCT 2003
Copyright © 2003 American Cancer Society
Volume 98, Issue 11, pages 2467–2472, 1 December 2003
How to Cite
Al-Othman, M. O. F., Morris, C. G., Logan, H. L., Hinerman, R. W., Amdur, R. J. and Mendenhall, W. M. (2003), Impact of race on outcome after definitive radiotherapy for squamous cell carcinoma of the head and neck. Cancer, 98: 2467–2472. doi: 10.1002/cncr.11822
- Issue online: 17 NOV 2003
- Version of Record online: 22 OCT 2003
- Manuscript Revised: 26 AUG 2003
- Manuscript Accepted: 26 AUG 2003
- Manuscript Received: 8 JUL 2003
- absolute survival;
- control rates;
- cause-specific survival;
The objective of the current study was to evaluate the impact of race (black vs. white) on the outcome of patients with invasive squamous cell carcinoma of the head and neck.
Between 1983 and 1997, 686 patients completed definitive, twice-daily radiotherapy (RT) alone or combined with a planned neck dissection; no patients received adjuvant chemotherapy. The minimum follow-up was 2 years, and median follow-up was 7 years for living patients. No patients were lost to follow-up. Fifty-five patients were black (8%).
Although the two groups had similar 5-year local-regional control rates (black patients vs. white patients: 70% vs. 76%, respectively; P = 0.275), black patients had double the risk for distant recurrence compared with white patients (27% vs. 13%; P = 0.012). The 5-year cause-specific and absolute survival rates were lower for black patients (52% vs. 74% [P = 0.001] and 29% vs. 52% [P < 0.001], respectively). Multivariate analyses revealed that race was an independent predictor of freedom from distant metastasis (P = 0.013), cause-specific survival (P = 0.005), and absolute survival (P < 0.001).
Although equal local-regional control rates can be achieved in black patients and white patients with squamous cell carcinoma of the head and neck, the risk of distant recurrence was significantly higher in black patients and resulted in decreased survival. Reevaluation of current strategies for pretreatment metastatic work-ups and development of more effective systemic therapy will be key to improving the survival disparity in this group. Cancer 2003. © 2003 American Cancer Society.