Comparison of clinical outcome in black and white women treated with radiotherapy for cervical carcinoma

Background. The purpose of this investigation was to evaluate the significa nce of race on the cancer-specific survival outcome of women treated with r adiotherapy for advanced-stage cancer of the uterine cervix. Methods. Data from 922 women with cancer of the uterine cen ix treated with radiotherapy were reviewed. Patients were treated at the Mallinckrodt Inst itute of Radiology from 1959 through 1993, There were 576 women with clinic al Stage II cancer and 346 women with clinical Stage III cancer. All women were treated following standard medical care treatment policies according t o the stage of their disease. Data were analyzed by race and known treatmen t-related prognostic factors. Overall and cancer-specific survivals were ev aluated. Results. The 5-year cancer-specific survivals for clinical Stage II were 66 and 61% (P = 0.56) for white and black women, respectively. The correspond ing 5-year overall survivals were 60 and 51% (P = 0.02). The 5-year cancer- specific survivals for clinical Stage III were 38 and 47% (P = 0.34) for wh ite and black women, respectively. The associated 5-year overall survivals were 32 and 40% (P = 0.37). No differences in treatment-related factors wer e identified. Conclusions. In a cancer treatment system where black and white women with clinical Stage II and III cancer of the uterine cervix are all treated with radiotherapy alone, following standard treatment policies, no significant difference in cancer-specific survival outcome is shown. Multivariate analy sis revealed that clinical stage and overall treatment time are significant variables affecting the control of tumor by radiotherapy. Overall survival s for the two racial groups are different and may be related to other non-c ancer-related factors. (C) 2000 Academic Press.