The influence of limited English proficiency on outcome in patients treated with radiotherapy for head and neck cancer.

Autor: Qureshi MM; Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, USA., Romesser PB; Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, USA., Jalisi S; Department of Otolaryngology, Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, USA., Zaner KS; Section of Hematology and Oncology, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, USA., Cooley TP; Section of Hematology and Oncology, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, USA., Grillone G; Department of Otolaryngology, Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, USA., Kachnic LA; Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, USA., Truong MT; Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, USA. Electronic address: mitruong@bu.edu.
Jazyk: angličtina
Zdroj: Patient education and counseling [Patient Educ Couns] 2014 Nov; Vol. 97 (2), pp. 276-82. Date of Electronic Publication: 2014 Aug 11.
DOI: 10.1016/j.pec.2014.07.031
Abstrakt: Objective: To evaluate how limited English proficiency affects treatment outcome in head and neck cancer (HNC) patients treated with curative intent radiation therapy (RT).
Methods: From 2004 to 2010, 131 patients with HNC underwent RT. Patient's self-reported primary language and race/ethnicity were obtained at hospital registration. English proficiency was categorized as being English proficient (EP) or limited English proficient (LEP). Race/ethnicity was categorized as white, black and other (Hispanics and Asians). Patients were evaluated for locoregional (LRC), distant control (DC), overall (OS) and disease-free (DFS) survival.
Results: Fewer LEP patients (60.0%) underwent chemoradiation compared to EP (83.8%), P=0.028. The three-year actuarial LRC for EP and LEP patients was 82.2% and 58.3%, respectively, P=0.038. LEP patients had an increased risk of locoregional failure on univariate Cox regression analysis (hazard ratio, HR 2.4, 95% CI, 1.0-5.8). No differences by English proficiency were seen for DC, OS and DFS. Race/ethnicity was not associated LRC, DC, OS and DFS.
Conclusion: Inferior locoregional control was observed in LEP patients receiving RT for HNC. Potential health disparities as a result of limited English proficiency require further investigation.
Practice Implications: Patient education, use of culturally sensitive interpreter and patient navigation services, and improved patient compliance should be considered in head and neck cancer patients receiving complex multidisciplinary care.
(Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: