title: Race impacts outcome in stage III/IV squamous cell carcinomas of the head and neck after concurrent chemoradiation therapy.
abstract: BACKGROUND
  The purpose of this study was to determine the impact of race on outcome in patients with stage III/IV squamous cell carcinoma of the head and neck (SCCHN) who have completed concurrent chemoradiotherapy.
  
  
  METHODS
  The authors performed a retrospective analysis of 202 patients with stage III/IV SCCHN who were treated at the University of Maryland. Patients received daily radiation to a total dose of 70.2 Gray (Gy) (1.8 Gy/day), concurrently with weekly carboplatin (area under the curve [AUC] = 2) and paclitaxel (45 mg/m(2)) chemotherapy.
  
  
  RESULTS
  There were 108 Caucasian (CA) and 94 African American (AA) patients. The median age was 56 years, and 81% were stage IV. The median follow-up was 33 months. The median overall survival (OS) and disease-free survival (DFS) were 33 months and 19 months, respectively. When analyzed by race, the median DFS was 33 months (CA) versus 12 months (AA) (P = .028). The median OS was 44 months (CA) versus 24 months (AA) (P = .071). The 3-year DFS for stage IV AA versus stage IV CA was 29% versus 50% (P = .031). The 3-year DFS for N2 disease in AA versus CA was 32% versus 51% (P = .046). The 3-year DFS for AA versus CA with oropharyngeal tumors was 30% versus 60% (P = .006).
  
  
  CONCLUSIONS
  This analysis documents the inferior outcome for AA patients. They had inferior DFS and a trend toward worse OS. When stratified by several prognostic variables, the mediocre DFS in the AA patients remains. These data suggest that further investigation into the genetic characteristics of SCCHN in AA patients is warranted.
authors.affiliation: Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Settle
authors.forename: Rodney
authors.initials: R
authors.lastname: Taylor
authors.forename: Jeffery
authors.initials: J
authors.lastname: Wolf
authors.forename: Young
authors.initials: Y
authors.lastname: Kwok
authors.forename: Kevin
authors.initials: K
authors.lastname: Cullen
authors.forename: Kevin
authors.initials: K
authors.lastname: Carter
authors.forename: Robert
authors.initials: R
authors.lastname: Ord
authors.forename: Ann
authors.initials: A
authors.lastname: Zimrin
authors.forename: Scott
authors.initials: S
authors.lastname: Strome
authors.forename: Mohan
authors.initials: M
authors.lastname: Suntharalingam
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000208:ethnology* / Q000532:radiotherapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000208:ethnology* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D044465:White People