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Title: Racial disparity in oncologic and quality-of-life outcomes in patients with locally advanced head and neck squamous cell carcinomas enrolled in a randomized phase 2 trial.

Authors: Guerriero, Margaret K; Redman, Mary W; Baker, Kelsey K; Martins, Renato G; Eaton, Keith; Chow, Laura Q; Santana-Davila, Rafael; Baik, Christina; Goulart, Bernardo H; Lee, Sylvia; Rodriguez, Cristina P

Published In Cancer, (2018 07 01)

Abstract: BACKGROUND: To better understand patient-reported quality of life (PRQOL) for patients with head and neck cancer, PRQOL scores were collected in a clinical trial. METHODS: Patients were randomized to arm A (70 Gy of radiation with cisplatin) or arm B (70 Gy of radiation with cisplatin plus erlotinib at 150 mg daily). PRQOL scores were measured on days -7 (arm B only), 0, 30, and 180 with the University of Washington Quality of Life Questionnaire. Associations with clinical factors and outcomes were explored with linear mixed, logistic, and Cox regression models. RESULTS: One hundred eighty-nine patients (97 in arm A and 92 in arm B) consented to PRQOL collection. Patients were balanced apart from more females in arm A (20 [21%] vs 8 [9%]; P = .02). There were 17 black patients (18%) in arm A and 12 (13%) in arm B (P = .39). There was no change in the mean scores in arm B from day -7 to day 0 (P = .36). Scores were lower in both arms at day 30 (P for both < .0001), with no difference by arm (P = .10). Scores on day 180 remained lower for arm A (-6.79; 95% confidence interval [CI], -12.6 to -1.0; P = .02). In arm B, this difference was not significant, and this suggested that the scores had returned to the baseline by day 180 (P = .73). After adjustments for potential confounders, black race was an independent predictor for inferior scores (-11.4; 95% CI, -16.84 to -5.94; P < .0001), complete response rates (odds ratio, 0.34; 95% CI, 0.12-0.91; P = .03), and overall survival (hazard ratio, 3.71; 95% CI, 1.63-8.47; P < .01). CONCLUSIONS: PRQOL scores predictably worsened during and improved after chemoradiation. Black patients had inferior PRQOL and overall survival. Cancer 2018;124:2841-2849. © 2018 American Cancer Society.

PubMed ID: 29669181 Exiting the NIEHS site

MeSH Terms: Adult; Aged; Antineoplastic Agents/administration & dosage; Antineoplastic Agents/adverse effects; Chemoradiotherapy/adverse effects*; Chemoradiotherapy/methods; Cisplatin/administration & dosage; Cisplatin/adverse effects; Continental Population Groups/statistics & numerical data; Erlotinib Hydrochloride/administration & dosage; Erlotinib Hydrochloride/adverse effects; Female; Head and Neck Neoplasms/ethnology; Head and Neck Neoplasms/mortality; Head and Neck Neoplasms/therapy*; Health Status Disparities*; Humans; Male; Middle Aged; Quality of Life*; Response Evaluation Criteria in Solid Tumors; Squamous Cell Carcinoma of Head and Neck/ethnology; Squamous Cell Carcinoma of Head and Neck/mortality; Squamous Cell Carcinoma of Head and Neck/therapy*; Survival Analysis

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