Race disparities attributed to volumetric tumor burden in patients with head and neck cancer treated with radiotherapy

Head Neck. 2016 Jan;38(1):126-34. doi: 10.1002/hed.23863. Epub 2015 Jun 16.

Abstract

Background: The purpose of this study was to evaluate how gross tumor volume (GTV) affects treatment outcome among different race/ethnic groups in patients with head and neck cancer receiving definitive radiotherapy (RT).

Methods: Ninety-one patients with head and neck cancer were treated to a median RT dose of 69.96 Gy in 33 fractions. The patient's self-reported race/ethnicity, primary tumor, and nodal GTV were obtained. Two-year actuarial local, nodal, and distant control, and overall and disease-free survival were calculated.

Results: The patients were categorized as white (n = 43) or non-white (n = 48), which included 29 African Americans, 11 Hispanics, 5 Asians, and 3 others. The mean primary GTV was 21.0 cc and 39.9 cc for whites and non-whites, respectively (p = .011). White patients reported improved overall survival of 85.4% compared to non-whites (65.8%; p = .006). Improvements in local and nodal control and disease-free survival rates were also observed.

Conclusion: White patients demonstrated improved treatment outcomes compared with non-whites, which may be reflective of tumor volume.

Keywords: ethnicity; gross tumor volume; head and neck cancer; race; radiotherapy.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Asian / statistics & numerical data*
  • Black or African American / statistics & numerical data*
  • Carcinoma, Squamous Cell / ethnology*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / ethnology*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Radiotherapy Dosage
  • Radiotherapy, Conformal / methods
  • Retrospective Studies
  • Tumor Burden / radiation effects
  • United States / epidemiology
  • White People / statistics & numerical data*