Impact of race on outcome after definitive radiotherapy for squamous cell carcinoma of the head and neck
Impact of race on outcome after definitive radiotherapy for squamous cell carcinoma of the head and neck
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DOI：
10.1002/cncr.11822
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发表时间：
2003-12-01
期刊：
影响因子：
6.2
通讯作者：
Mendenhall, WM
中科院分区：
文献类型：
--
作者：
Al-Othman, MOF;Morris, CG;Mendenhall, WM
背景。本研究的目的是评估种族（黑人与白人）对头颈部浸润性鳞状细胞癌患者预后的影响。方法。 1983年至1997年间，686名患者完成了明确的、每日两次的单独放疗（RT）或与计划的颈清扫术相结合；没有患者接受辅助化疗。对于活着的患者，最短随访时间为 2 年，中位随访时间为 7 年。没有患者失访。 55 名患者是黑人 (8%)。 结果。尽管两组的 5 年局部区域控制率相似（黑人患者与白人患者：分别为 70% vs. 76%；P = 0.275），但黑人患者的远处复发风险是白人患者的两倍（27% vs. 13%；P = 0.012）。黑人患者的 5 年病因特异性生存率和绝对生存率较低（分别为 52% vs. 74% [P = 0.001] 和 29% vs. 52% [P < 0.001]）。多变量分析显示，种族是无远处转移（P = 0.013）、原因特异性生存（P = 0.005）和绝对生存（P < 0.001）的独立预测因素。结论。尽管头颈部鳞状细胞癌黑人患者和白人患者可以实现相同的局部区域控制率，但黑人患者远处复发的风险明显更高，并导致生存率下降。重新评估当前治疗前转移检查的策略和开发更有效的全身治疗将是改善该群体生存差异的关键。 (C) 2003 年美国癌症协会。
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. (C) 2003 American Cancer Society.