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BMC Cancer
Published in: BMC Cancer 1/2013

Open Access 01-12-2013 | Research article

Early results of prostate cancer radiation therapy: an analysis with emphasis on research strategies to improve treatment delivery and outcomes

Authors: Kosj Yamoah, Kwamena Beecham, Sarah E Hegarty, Terry Hyslop, Timothy Showalter, Joel Yarney

Published in: BMC Cancer | Issue 1/2013

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Abstract

Background

There is scant data regarding disease presentation and treatment response among black men living in Africa. In this study we evaluate disease presentation and early clinical outcomes among Ghanaian men with prostate cancer treated with external beam radiotherapy (EBRT).

Methods

A total of 379 men with prostate cancer were referred to the National Center for Radiotherapy, Ghana from 2003 to 2009. Data were collected regarding patient-and tumor-related factors such as age, prostate specific antigen (PSA), Gleason score (GS), clinical stage (T), and use of androgen deprivation therapy (ADT). For patients who received EBRT, freedom from biochemical failure (FFbF) was evaluated using the Kaplan-Meier method.

Results

Of 379 patients referred for treatment 69.6% had initial PSA (iPSA) > 20 ng/ml, and median iPSA was 39.0 ng/ml. A total of 128 men, representing 33.8% of the overall cohort, were diagnosed with metastatic disease at time of referral. Among patients with at least 2 years of follow-up after EBRT treatment (n=52; median follow-up time: 38.9 months), 3- and 5-year actuarial FFbF was 73.8% and 65.1% respectively. There was significant association between higher iPSA and GS (8–10 vs. ≤7, p < 0.001), and T stage (T3/4 vs. T1/2, p < 0.001).

Conclusions

This is the largest series reporting on outcomes after prostate cancer treatment in West Africa. That one-third of patients presented with metastatic disease suggests potential need for earlier detection to permit curative-intent therapy. Data from this study will aid in the strategic development of prostate cancer research roadmap in Ghana.

Literature
  1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM: Estimates of worldwide burden of cancer in, GLOBOCAN 2008. Int J Cancer. 2008, 127 (12): 2893-2917.View Article
  2. Center MM, Jemal A, Lortet-Tieulent J, Ward E, Ferlay J, Brawley O, Bray F: International variation in prostate cancer incidence and mortality rates. Eur Urol. 2012, 61 (6): 1079-1092. 10.1016/j.eururo.2012.02.054.View ArticlePubMed
  3. Jemal A, Bray F, Forman D, O'Brien M, Ferlay J, Center M, Parkin DM: Cancer burden in Africa and opportunities for prevention. Cancer. 2012, 118 (18): 4372-4384. 10.1002/cncr.27410.View ArticlePubMed
  4. Freeman HP, Muth BJ, Kerner JF: Expanding access to cancer screening and clinical follow-up among the medically underserved. Cancer Pract. 1995, 3 (1): 19-30.PubMed
  5. Underwood SM: Reducing the burden of cancer borne by African Americans: if not now, when?. Cancer Epidemiol Biomarkers Prev. 2003, 12 (3): 270s-276s.PubMed
  6. Haiman CA, Chen GK, Blot WJ, Strom SS, Berndt SI, Kittles RA, Rybicki BA, Isaacs WB, Ingles SA, Stanford JL, et al: Genome-wide association study of prostate cancer in men of African ancestry identifies a susceptibility locus at 17q21. Nat Genet. 2011, 43 (6): 570-573. 10.1038/ng.839.View ArticlePubMedPubMed Central
  7. Wandel C, Witte JS, Hall JM, Stein CM, Wood AJ, Wilkinson GR: CYP3A activity in African American and European American men: population differences and functional effect of the CYP3A4*1B5′-promoter region polymorphism. Clin Pharmacol Ther. 2000, 68 (1): 82-91. 10.1067/mcp.2000.108506.View ArticlePubMed
  8. Powell IJ, Land SJ, Dey J, Heilbrun LK, Hughes MR, Sakr W, Everson RB: The impact of CAG repeats in exon 1 of the androgen receptor on disease progression after prostatectomy. Cancer. 2005, 103 (3): 528-537. 10.1002/cncr.20788.View ArticlePubMed
  9. Albain KS, Unger JM, Crowley JJ, Coltman CA, Hershman DL: Racial disparities in cancer survival among randomized clinical trials patients of the Southwest oncology group. J Natl Cancer Inst. 2009, 101 (14): 984-992. 10.1093/jnci/djp175.View ArticlePubMedPubMed Central
  10. Thompson I, Tangen C, Tolcher A, Crawford E, Eisenberger M, Moinpour C: Association of African-American ethnic background with survival in men with metastatic prostate cancer. J Natl Cancer Inst. 2001, 93 (3): 219-225. 10.1093/jnci/93.3.219.View ArticlePubMed
  11. Fowler JE, Terrell F: Survival in blacks and whites after treatment for localized prostate cancer. J Urol. 1996, 156 (1): 133-136. 10.1016/S0022-5347(01)65966-4.View ArticlePubMed
  12. Roach M, Krall J, Keller JW, Perez CA, Sause WT, Doggett RL, Rotman M, Russ H, Pilepich MV, Asbell SO, et al: The prognostic significance of race and survival from prostate cancer based on patients irradiated on Radiation Therapy Oncology Group protocols (1976–1985). Int J Radiat Oncol Biol Phys. 1992, 24 (3): 441-449. 10.1016/0360-3016(92)91058-U.View ArticlePubMed
  13. Robbins AS, Whittemore AS, Van Den Eeden SK: Race, prostate cancer survival, and membership in a large health maintenance organization. J Natl Cancer Inst. 1998, 90 (13): 986-990. 10.1093/jnci/90.13.986.View ArticlePubMed
  14. Yamoah K, Stone N, Stock R: Impact of race on biochemical disease recurrence after prostate brachytherapy. Cancer. 2011, 117 (24): 5589-5600. 10.1002/cncr.26183.View ArticlePubMed
  15. Odedina FT, Ogunbiyi JO, Ukoli FA: Roots of prostate cancer in African-American men. J Natl Med Assoc. 2006, 98 (4): 539-543.PubMedPubMed Central
  16. Odedina FT, Akinremi TO, Chinegwundoh F, Roberts R, Yu D, Reams RR, Freedman ML, Rivers B, Green BL, Kumar N: Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa. Infect Agent Cancer. 2009, 4 (Suppl 1): S2-10.1186/1750-9378-4-S1-S2.View ArticlePubMedPubMed Central
  17. Klufio GO: A review of genitourinary cancers at the Korle-Bu teaching hospital Accra, Ghana. West Afr J Med. 2004, 23 (2): 131-134.PubMed
  18. Wiredu EK, Armah HB: Cancer mortality patterns in Ghana: a 10-year review of autopsies and hospital mortality. BMC Public Health. 2006, 6: 159-10.1186/1471-2458-6-159.View ArticlePubMedPubMed Central
  19. Yarney J, Vanderpuye V, Mensah J: Clinicopathologic features and determinants of Gleason score of prostate cancer in Ghanaian men. Urol Oncol. 2011, Mar 25. [Epub ahead of print-10.1016/j.urolonc.2011.01.018]
  20. Gueye SM, Zeigler-Johnson CM, Friebel T, Spangler E, Jalloh M, MacBride S, Malkowicz SB, Rebbeck TR: Clinical characteristics of prostate cancer in African Americans, American whites, and Senegalese men. Urology. 2003, 61 (5): 987-992. 10.1016/S0090-4295(02)02588-8.View ArticlePubMed
  21. Zietman AL, DeSilvio ML, Slater JD, Rossi CJ, Miller DW, Adams JA, Shipley WU: Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA. 2005, 294 (10): 1233-1239. 10.1001/jama.294.10.1233.View ArticlePubMed
  22. Edge SB, Compton CC: The American joint committee on cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010, 17 (6): 1471-1474. 10.1245/s10434-010-0985-4.View ArticlePubMed
  23. Mohler JL: The 2010 NCCN clinical practice guidelines in oncology on prostate cancer. J Natl Compr Canc Netw. 2010, 8 (2): 145-PubMed
  24. Yamoah K, Stone N, Stock R: Impact of race on biochemical disease recurrence after prostate brachytherapy. Cancer. 2011, 117 (24): 5589-5600. 10.1002/cncr.26183.View ArticlePubMed
  25. Hanks GE, Pajak TF, Porter A, Grignon D, Brereton H, Venkatesan V, Horwitz EM, Lawton C, Rosenthal SA, Sandler HM, et al: Phase III trial of long-term adjuvant androgen deprivation after neoadjuvant hormonal cytoreduction and radiotherapy in locally advanced carcinoma of the prostate: the radiation therapy oncology group protocol 92–02. J Clin Oncol. 2003, 21 (21): 3972-3978. 10.1200/JCO.2003.11.023.View ArticlePubMed
  26. Roach M, Hanks G, Thames H, Schellhammer P, Shipley WU, Sokol GH, Sandler H: Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys. 2006, 65 (4): 965-974. 10.1016/j.ijrobp.2006.04.029.View ArticlePubMed
  27. Reeler AV, Mellstedt H: Cancer in developing countries: challenges and solutions. Ann Oncol. 2006, 17 (Suppl 8): viii7-viii8.PubMed
  28. Mellstedt H: Cancer initiatives in developing countries. Ann Oncol. 2006, 17 (Suppl 8): viii24-viii31.PubMed
  29. Ekwere PD, Egbe SN: The changing pattern of prostate cancer in Nigerians: current status in the southeastern states. J Natl Med Assoc. 2002, 94 (7): 619-627.PubMedPubMed Central
  30. Udeh FN: Prostatic carcinoma in Nigeria: a 10-year retrospective study. Int Urol Nephrol. 1981, 13 (2): 159-166. 10.1007/BF02082060.View ArticlePubMed
  31. Ogunbiyi JO, Shittu OB: Increased incidence of prostate cancer in Nigerians. J Natl Med Assoc. 1999, 91 (3): 159-164.PubMedPubMed Central
  32. Jones CU, Hunt D, McGowan DG, Amin MB, Chetner MP, Bruner DW, Leibenhaut MH, Husain SM, Rotman M, Souhami L, et al: Radiotherapy and short-term androgen deprivation for localized prostate cancer. N Engl J Med. 2011, 365 (2): 107-118. 10.1056/NEJMoa1012348.View ArticlePubMed
  33. Sohayda CJ, Kupelian PA, Altsman KA, Klein EA: Race as an independent predictor of outcome after treatment for localized prostate cancer. J Urol. 1999, 162 (4): 1331-1336. 10.1016/S0022-5347(05)68279-1.View ArticlePubMed
  34. D’Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, Tomaszewski JE, Renshaw AA, Kaplan I, Beard CJ, et al: Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA. 1998, 280 (11): 969-974. 10.1001/jama.280.11.969.View ArticlePubMed
  35. Lin K, Croswell JM, Koenig H, Lam C, Maltz A: Prostate-Specific Antigen-Based Screening for Prostate Cancer: An Evidence Update for the U.S. Preventive Services Task Force. 2011, Rockville (MD): Agency for Healthcare Research and Quality (US), Report No.: 12-05160-EF-1
  36. Roobol MJ, Kerkhof M, Schroder FH, Cuzick J, Sasieni P, Hakama M, Stenman UH, Ciatto S, Nelen V, Kwiatkowski M, et al: Prostate cancer mortality reduction by prostate-specific antigen-based screening adjusted for nonattendance and contamination in the European Randomised Study of Screening for Prostate Cancer (ERSPC). Eur Urol. 2009, 56 (4): 584-591. 10.1016/j.eururo.2009.07.018.View ArticlePubMed
  37. Studer UE, Collette L: What can be concluded from the ERSPC and PLCO trial data?. Urol Oncol. 2010, 28 (6): 668-669. 10.1016/j.urolonc.2010.03.011.View ArticlePubMed
  38. Boike TP, Lotan Y, Cho LC, Brindle J, DeRose P, Xie XJ, Yan J, Foster R, Pistenmaa D, Perkins A, et al: Phase I dose-escalation study of stereotactic body radiation therapy for low- and intermediate-risk prostate cancer. J Clin Oncol. 2011, 29 (15): 2020-2026. 10.1200/JCO.2010.31.4377.View ArticlePubMedPubMed Central
  39. Horwitz EM, Bae K, Hanks GE, Porter A, Grignon DJ, Brereton HD, Venkatesan V, Lawton CA, Rosenthal SA, Sandler HM, et al: Ten-year follow-up of radiation therapy oncology group protocol 92–02: a phase III trial of the duration of elective androgen deprivation in locally advanced prostate cancer. J Clin Oncol. 2008, 26 (15): 2497-2504. 10.1200/JCO.2007.14.9021.View ArticlePubMed
  40. Bolla M, Collette L, Blank L, Warde P, Dubois JB, Mirimanoff RO, Storme G, Bernier J, Kuten A, Sternberg C, et al: Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial. Lancet. 2002, 360 (9327): 103-106. 10.1016/S0140-6736(02)09408-4.View ArticlePubMed
  41. Pilepich MV, Winter K, Lawton CA, Krisch RE, Wolkov HB, Movsas B, Hug EB, Asbell SO, Grignon D: Androgen suppression adjuvant to definitive radiotherapy in prostate carcinoma–long-term results of phase III RTOG 85–31. Int J Radiat Oncol Biol Phys. 2005, 61 (5): 1285-1290. 10.1016/j.ijrobp.2004.08.047.View ArticlePubMed
    1. The pre-publication history for this paper can be accessed here:http://​www.​biomedcentral.​com/​1471-2407/​13/​23/​prepub
Metadata
Title
Early results of prostate cancer radiation therapy: an analysis with emphasis on research strategies to improve treatment delivery and outcomes
Authors
Kosj Yamoah
Kwamena Beecham
Sarah E Hegarty
Terry Hyslop
Timothy Showalter
Joel Yarney
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2013
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-13-23

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