Race disparities attributed to volumetric tumor burden in patients with head and neck cancer treated with radiotherapy

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. Conclusion White patients demonstrated improved treatment outcomes compared with non‐whites, which may be reflective of tumor volume. © 2015 Wiley Periodicals, Inc. Head Neck 38: 126–134, 2016