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Impact of race on outcome after definitive radiotherapy for squamous cell carcinoma of the head and neck

  1. Majid O. F. Al-Othman M.D.1,
  2. Christopher G. Morris M.S.1,
  3. Henrietta L. Logan Ph.D.2,
  4. Russell W. Hinerman M.D.1,
  5. Robert J. Amdur M.D.1,
  6. William M. Mendenhall M.D.1,†,*

Article first published online: 22 OCT 2003

DOI: 10.1002/cncr.11822

Issue

Cancer

Cancer

Volume 98, Issue 11, pages 2467–2472, 1 December 2003

Additional Information

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

Author Information

  1. 1

    Department of Radiation Oncology, College of Medicine, University of Florida, Gainesville, Florida

  2. 2

    Division of Public Health Services and Research, College of Dentistry, University of Florida, Gainesville, Florida

  1. †

    Fax: (352) 265-0759

*Department of Radiation Oncology, P.O. Box 100385, Gainesville, FL 32610-0385

Publication History

  1. Issue published online: 17 NOV 2003
  2. Article first published online: 22 OCT 2003
  3. Manuscript Revised: 26 AUG 2003
  4. Manuscript Accepted: 26 AUG 2003
  5. Manuscript Received: 8 JUL 2003

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Keywords:

  • absolute survival;
  • control rates;
  • cause-specific survival;
  • radiotherapy;
  • recurrence

Abstract

BACKGROUND

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.

METHODS

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%).

RESULTS

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).

CONCLUSIONS

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.

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