The first two authors contributed equally to this work.
Racial parities in outcomes after radiotherapy for head and neck cancer
Article first published online: 10 OCT 2013
© 2013 American Cancer Society
Volume 120, Issue 2, pages 244–252, 15 January 2014
How to Cite
Liu, G.-F. F., Ranck, M. C., Solanki, A. A., Cao, H., Kolokythas, A., Wenig, B. L., Chen, L., Ard, S., Weichselbaum, R. R., Halpern, H. and Spiotto, M. T. (2014), Racial parities in outcomes after radiotherapy for head and neck cancer. Cancer, 120: 244–252. doi: 10.1002/cncr.28417
- Issue published online: 7 JAN 2014
- Article first published online: 10 OCT 2013
- Manuscript Accepted: 26 AUG 2013
- Manuscript Revised: 20 JUL 2013
- Manuscript Received: 10 JUL 2013
- head and neck neoplasms;
- minority health;
- outcomes assessment;
- minority groups
Although black patients experience worse outcomes after treatment for squamous cell carcinoma of the head and neck (HNSCC), these conclusions were based on populations in which blacks comprised a minority of patients. The objective of the current study was to determine the impact of race on outcomes in patients with HNSCC who received radiotherapy at an institution in which blacks comprised the majority of patients.
In this retrospective cohort study, the authors reviewed 366 black patients and 236 white patients who had nonmetastatic HNSCC for which they received radiotherapy between 1990 and 2012. The primary study outcome measures were locoregional control, freedom from distant metastasis, progression-free survival, and overall survival.
The median follow-up was 18.3 months for all patients. The 2-year locoregional control rate was 71.9% for black patients compared with 64.2% for white patients (hazard ratio, 0.72; P = .03). There was no difference between blacks and whites regarding 2-year freedom from distant metastasis, progression-free survival, or overall survival. Among the patients who had stage III through IVB disease, blacks and whites had similar outcomes. On multivariate analysis, race was not statistically significant for locoregional control, freedom from distant metastasis, progression-free survival, or overall survival. Despite these similar outcomes, black patients had worse socioeconomic factors and increased comorbidities but had similar treatment compliance compared with white patients.
With more adverse prognostic factors, black patients experienced oncologic outcomes similar to the outcomes of white patients after receiving radiotherapy for HNSCC. The current data suggest that centers that treat large percentages of minority patients who receive radiotherapy for HNSCCs may overcome existing health care disparities through improved treatment compliance. Cancer 2014;120:244–252. © 2013 American Cancer Society.