title: Race disparities attributed to volumetric tumor burden in patients with head and neck cancer treated with radiotherapy.
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.
  
  
  CONCLUSIONS
  White patients demonstrated improved treatment outcomes compared with non-whites, which may be reflective of tumor volume.
authors.affiliation: Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Muhammad M
authors.initials: MM
authors.lastname: Qureshi
authors.affiliation: Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Romesser
authors.affiliation: Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Abdallah
authors.initials: A
authors.lastname: Ajani
authors.affiliation: Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Kachnic
authors.affiliation: Department of Otolaryngology, Division of Head and Neck Surgical Oncology and Skull Base Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Scharukh
authors.initials: S
authors.lastname: Jalisi
authors.affiliation: Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Minh Tam
authors.initials: MT
authors.lastname: Truong
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D002294:Carcinoma, Squamous Cell / Q000208:ethnology* / Q000473:pathology / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000208:ethnology* / Q000473:pathology / Q000532:radiotherapy*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods; D012189:Retrospective Studies; D047368:Tumor Burden / Q000528:radiation effects; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
keywords: ethnicity; gross tumor volume; head and neck cancer; race; radiotherapy