Race and clinical outcome in patients with carcinoma of the uterine cervixtreated with radiation therapy

Objectives. The aim of this study was to examine factors underlying differe nces in outcome between African-American (AA) and Caucasian (C) patients un dergoing radiation therapy CRT). Methods. Patient, tumor, treatment characteristics, and the outcome of 316 AA and 94 C cervical cancer patients who underwent RT were compared. Median follow-up was 72.4 months. Results. AA patients had a trend to a poorer 8-year cause-specific survival (47.9 vs 60.6%) (P = 0.10) compared to C patients with a significant diffe rence seen in stage IIB-IVA disease (34.3 vs 59.5%) (P = 0.04). Several fac tors correlated with poor outcome were present in the AA group including lo wer mean hemoglobin levels during RT (P = 0.001), lower median income (P = 0.001), and less frequent intracavitary RT (P = 0.09). In addition, while u ncommon in C patients, health problems were major reasons for treatment pro traction and inability to undergo intracavitary RT in the AA patients. Mult ivariate analysis demonstrated that race was not an independent prognostic factor after controlling for difference in patient, tumor, and treatment fa ctors. Conclusions. AA cervical cancer patients possess multiple factors that adve rsely impact upon the efficacy of RT. These findings may add further insigh t into the observed differences in outcome of cervical cancer patients base d on race. (C) 1998 Academic Press.