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

Thomas J. Dilling, Kyounghwa Bae, Rebecca Paulus, Deborah Watkins-Bruner, Adam S. Garden, Arlene A. Forastiere, K. Kian Ang, Benjamin Movsas

Research output: Contribution to journalArticle

Abstract

Purpose: 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 and Materials: 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.

Original languageEnglish (US)
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume81
Issue number3
DOIs
StatePublished - Nov 1 2011

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Radiation Oncology
Head and Neck Neoplasms
radiation therapy
Radiotherapy
cancer
Survival
hazards
confidence
Confidence Intervals
intervals
Arm
homogeneity
Neck
Survival Rate
Head

Keywords

  • Gender
  • Head and neck cancer
  • Partner status
  • Race

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

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. / Dilling, Thomas J.; Bae, Kyounghwa; Paulus, Rebecca; Watkins-Bruner, Deborah; Garden, Adam S.; Forastiere, Arlene A.; Kian Ang, K.; Movsas, Benjamin.

In: International Journal of Radiation Oncology, Biology, Physics, Vol. 81, No. 3, 01.11.2011.

Research output: Contribution to journalArticle

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abstract = "Purpose: 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 and Materials: 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.",
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AU - Paulus, Rebecca

AU - Watkins-Bruner, Deborah

AU - Garden, Adam S.

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AU - Kian Ang, K.

AU - Movsas, Benjamin

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