Racial Parities in Outcomes After Radiotherapy for Head and Neck Cancer

被引:22
作者
Liu, Gene-Fu F. [1 ]
Ranck, Mark C. [1 ]
Solanki, Abhishek A. [1 ]
Cao, Hongyuan [2 ]
Kolokythas, Antonia [3 ]
Wenig, Barry L. [4 ]
Chen, Lucy [5 ]
Ard, Stephanie [6 ]
Weichselbaum, Ralph R. [1 ,6 ]
Halpern, Howard [1 ,6 ]
Spiotto, Michael T. [1 ,6 ]
机构
[1] Univ Chicago Med Ctr, Dept Radiat & Cellular Oncol, Chicago, IL USA
[2] Univ Chicago, Dept Hlth Studies, Chicago, IL 60637 USA
[3] Univ Illinois Hosp & Hlth Sci Syst, Dept Oral & Maxillofacial Surg, Chicago, IL USA
[4] Univ Illinois Hosp & Hlth Sci Syst, Dept Otolaryngol Head & Neck Surg, Chicago, IL USA
[5] Univ Illinois Hosp & Hlth Sci Syst, Sect Hematol & Oncol, Chicago, IL USA
[6] Univ Illinois Hosp & Hlth Sci Syst, Dept Radiat Oncol, Chicago, IL USA
关键词
radiotherapy; head and neck neoplasms; minority health; outcomes assessment; minority groups; SQUAMOUS-CELL CARCINOMA; HUMAN-PAPILLOMAVIRUS; AFRICAN-AMERICAN; RACE; SURVIVAL; DISPARITIES; ETHNICITY; IMPACT; STAGE;
D O I
10.1002/cncr.28417
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUNDAlthough 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. METHODSIn 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. RESULTSThe 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. CONCLUSIONSWith 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. (c) 2013 American Cancer Society. Although multiple investigators have observed racial differences in outcomes among patients with head and neck cancers, these conclusions are based on studies in which black patients comprised <20% of the patient population. When assessing outcomes after radiotherapy at a center in which black patients comprise the majority, disease control and overall survival did not differ by patient race despite worse prognostic factors.
引用
收藏
页码:244 / 252
页数:9
相关论文
共 26 条
  • [11] Racial differences in trust and lung cancer patients' perceptions of physician communication
    Gordon, HS
    Street, RL
    Sharf, BF
    Kelly, PA
    Souchek, J
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2006, 24 (06) : 904 - 909
  • [12] Racial disparities in patients with head and neck squamous cell carcinoma
    Gourin, Christine G.
    Podolsky, Robert H.
    [J]. LARYNGOSCOPE, 2006, 116 (07) : 1093 - 1106
  • [13] Karnofsky DA., 1949, CLIN EVALUATION CHEM
  • [14] Race and Ethnicity and Breast Cancer Outcomes in an Underinsured Population
    Komenaka, Ian K.
    Martinez, Maria Elena
    Pennington, Robert E., Jr.
    Hsu, Chiu-Hsieh
    Clare, Susan E.
    Thompson, Patricia A.
    Murphy, Colleen
    Zork, Noelia M.
    Goulet, Robert J., Jr.
    [J]. JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2010, 102 (15) : 1178 - 1187
  • [15] African American and Poor Patients Have a Dramatically Worse Prognosis for Head and Neck Cancer An Examination of 20,915 Patients
    Molina, Manuel A.
    Cheung, Michael C.
    Perez, Eduardo A.
    Byrne, Margaret M.
    Franceschi, Dido
    Moffat, Frederick L.
    Livingstone, Alan S.
    Goodwin, W. Jarrard
    Gutierrez, Juan C.
    Koniaris, Leonidas G.
    [J]. CANCER, 2008, 113 (10) : 2797 - 2806
  • [16] Racial disparity in survival of patients with squamous cell carcinoma of the oral cavity and pharynx
    Moore, RJ
    Doherty, DA
    Do, KA
    Chamberlain, RM
    Khuri, FR
    [J]. ETHNICITY & HEALTH, 2001, 6 (3-4) : 165 - 177
  • [17] Murdock JM, 2001, CANCER, V91, P279, DOI 10.1002/1097-0142(20010101)91:1+<279::AID-CNCR19>3.0.CO
  • [18] 2-X
  • [19] Racial differences in stage and survival in head and neck squamous cell carcinoma
    Nichols, Anthony C.
    Bhattacharyya, Neil
    [J]. LARYNGOSCOPE, 2007, 117 (05) : 770 - 775
  • [20] Population-Based Study of Competing Mortality in Head and Neck Cancer
    Rose, Brent S.
    Jeong, Jong-Hyeon
    Nath, Sameer K.
    Lu, Sharon M.
    Mell, Loren K.
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (26) : 3503 - 3509