Genitourinary Cancer

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SU_23_2230 - Definitive Radiation Treatment Patterns and Outcomes for Low Intermediate Risk Prostate Cancer - A Cross Continental Comparative Study Between Ghana and the United States of America

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Definitive Radiation Treatment Patterns and Outcomes for Low Intermediate Risk Prostate Cancer - A Cross Continental Comparative Study Between Ghana and the United States of America
F. A. Asamoah1,2, J. Yarney1, V. Vanderpuye1, S. Awasthi2, P. S. Venkat2, M. A. Dadzie1, A. O. Naghavi2, J. Mensah1, A. Abrahams1, and K. Yamoah2; 1Korle Bu Teaching Hospital, Accra, Ghana, 2H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL

Purpose/Objective(s): There is limited data on Native African Men (NAM) treated by radiotherapy for prostate cancer (PCa). In this study we evaluate treatment patterns and outcomes among PCa patients in Ghana compared to a similar cohort in the United States of America (US).

Materials/Methods: This retrospective study consisted of 1009 National Comprehensive Cancer Network (NCCN) low and intermediate risk PCa patients (150 NAM from Ghana, 859 from US). Differences in covariates and baseline characteristics were analyzed using Fisher exact test and Mann Whitney test. Survival analysis was used to estimate the risk of biochemical recurrence (BCR).

Results: Median follow up was 33 months. NAM were diagnosed at a younger median age than US men (64yrs vs 68yrs, p < 0.001). The median definitive external beam radiation dose was 72.4Gy (IQR: 70 -74Gy) for NAM and 78Gy (IQR: 75.6 - 79.2Gy) for US men, p < 0.001. NAM were more likely to receive androgen deprivation therapy (ADT) compared to US men (47.3% vs 21.3%, p < 0.001). US men were more likely to receive combined external beam radiation and brachytherapy compared to NAM (27.2% vs 1.3%, p < 0.0001). The median time to commence radiation treatment after prostate cancer diagnosis was not significantly different between NAM and US men (4 months vs 3 months, p = 0.8). The 5 year actuarial freedom from biochemical failure was 77% (95% CI: 64 - 86%) vs 93% (95% CI: 91 - 95%) for NAM and US men respectively. In a treatment adjusted Cox Proportional Hazards model, NAM had significantly higher risk of BCR (Hazard Ratio = 4.29, 95% CI: 1.95 - 9.42, p < 0.001).

Conclusion: Compared to US men, native African men achieve less durable disease control following standard treatment recommendations. Result may suggest radiation treatment dose/delivery and/or inherent biological differences between the two populations. This data will aid in developing research strategies to improve treatment outcomes in NAM.

Author Disclosure: F.A. Asamoah: None. J. Yarney: Travel Expenses; Varian Medical Systems Inc. V. Vanderpuye: None. S. Awasthi: None. P.S. Venkat: None. M. Dadzie: None.

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