title: Impact of gender, partner status, and race on locoregional failure and overall survival in head and neck cancer patients in three radiation therapy oncology group trials.
abstract: OBJECTIVE
  We investigated the impact of race, in conjunction with gender and partner status, on locoregional control (LRC) and overall survival (OS) in three head and neck trials conducted by the Radiation Therapy Oncology Group (RTOG).
  
  
  METHODS
  Patients from RTOG studies 9003, 9111, and 9703 were included. Patients were stratified by treatment arms. Covariates of interest were partner status (partnered vs. non-partnered), race (white vs. non-white), and sex (female vs. male). Chi-square testing demonstrated homogeneity across treatment arms. Hazards ratio (HR) was used to estimate time to event outcome. Unadjusted and adjusted HRs were calculated for all covariates with associated 95% confidence intervals (CIs) and p values.
  
  
  RESULTS
  A total of 1,736 patients were analyzed. Unpartnered males had inferior OS rates compared to partnered females (adjusted HR = 1.22, 95% CI, 1.09-1.36), partnered males (adjusted HR = 1.20, 95% CI, 1.09-1.28), and unpartnered females (adjusted HR = 1.20, 95% CI, 1.09-1.32). White females had superior OS compared with white males, non-white females, and non-white males. Non-white males had inferior OS compared to white males. Partnered whites had improved OS relative to partnered non-white, unpartnered white, and unpartnered non-white patients. Unpartnered males had inferior LRC compared to partnered males (adjusted HR = 1.26, 95% CI, 1.09-1.46) and unpartnered females (adjusted HR = 1.30, 95% CI, 1.05-1.62). White females had LRC superior to non-white males and females. White males had improved LRC compared to non-white males. Partnered whites had improved LRC compared to partnered and unpartnered non-white patients. Unpartnered whites had improved LRC compared to unpartnered non-whites.
  
  
  CONCLUSIONS
  Race, gender, and partner status had impacts on both OS and locoregional failure, both singly and in combination.
authors.affiliation: Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA. Thomas.Dilling@moffitt.org
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Dilling
authors.forename: Kyounghwa
authors.initials: K
authors.lastname: Bae
authors.forename: Rebecca
authors.initials: R
authors.lastname: Paulus
authors.forename: Deborah
authors.initials: D
authors.lastname: Watkins-Bruner
authors.forename: Adam S
authors.initials: AS
authors.lastname: Garden
authors.forename: Arlene
authors.initials: A
authors.lastname: Forastiere
authors.forename: K
authors.initials: K
authors.lastname: Kian Ang
authors.forename: Benjamin
authors.initials: B
authors.lastname: Movsas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000208:ethnology / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy / Q000379:methods / Q000401:mortality; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D005260:Female; D006258:Head and Neck Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D016016:Proportional Hazards Models; D012737:Sex Factors; D016019:Survival Analysis; D055815:Young Adult