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Impact of Race on Outcomes of High-Risk Patients With Prostate Cancer Treated With Moderately Hypofractionated Radiotherapy in an Equal Access Setting.

Publication ,  Journal Article
Carpenter, DJ; Natesan, D; Floyd, RW; Oyekunle, T; Niedzwiecki, D; Waters, L; Godfrey, D; Moravan, MJ; Bitting, RL; Gingrich, JR; Lee, WR; Salama, JK
Published in: Fed Pract
August 2022

BACKGROUND: Moderately hypofractionated radiotherapy (MHRT) is an accepted treatment for localized prostate cancer; however, limited MHRT data address high-risk prostate cancer (HRPC) and/or African American patients. We report clinical outcomes and toxicity profiles for individuals with HRPC treated in an equal access system. METHODS: We identified patients with HRPC treated with MHRT at a US Department of Veterans Affairs referral center. Exclusion criteria included < 12 months follow-up and elective nodal irradiation. MHRT included 70 Gy over 28 fractions or 60 Gy over 20 fractions. Acute and late gastrointestinal (GI) and genitourinary (GU) toxicities were graded using Common Terminology Criteria for Adverse Events, version 5.0. Clinical endpoints, including biochemical recurrence-free survival (BRFS), distant metastases-free survival (DMFS), overall survival (OS), and prostate cancer-specific survival (PCSS) were estimated using Kaplan-Meier methods. Clinical outcomes, acute toxicity, and late toxicity-free survival were compared between African American and White patients with logistic regression and log-rank testing. RESULTS: Between November 2008 and August 2018, 143 patients with HRPC were treated with MHRT and followed for a median of 38.5 months; 82 (57%) were African American and 61 were White patients. Concurrent androgen deprivation therapy (ADT) was provided for 138 (97%) patients for a median duration of 24 months. No significant differences between African American and White patients were observed for 5-year OS (73% [95% CI, 58%-83%] vs 77% [95% CI, 60%-97%]; P = .55), PCSS (90% [95% CI, 79%-95%] vs 87% [95 % CI, 70%-95%]; P = .57), DMFS (91% [95% CI, 80%-96%] vs 81% [95% CI, 62%-91%]; P = .55), or BRFS (83% [95% CI, 70%-91%] vs 71% [95% CI, 53%-82%]; P = .57), respectively. Rates of acute grade 3+ GU and GI were low overall (4% and 1%, respectively). Late toxicities were similarly favorable with no significant differences by race. CONCLUSIONS: Individuals with HRPC treated with MHRT in an equal access setting demonstrated favorable clinical outcomes that did not differ by race, alongside acceptable rates of acute and late toxicities.

Duke Scholars

Published In

Fed Pract

DOI

ISSN

1078-4497

Publication Date

August 2022

Volume

39

Issue

Suppl 3

Start / End Page

S35 / S41

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Carpenter, D. J., Natesan, D., Floyd, R. W., Oyekunle, T., Niedzwiecki, D., Waters, L., … Salama, J. K. (2022). Impact of Race on Outcomes of High-Risk Patients With Prostate Cancer Treated With Moderately Hypofractionated Radiotherapy in an Equal Access Setting. Fed Pract, 39(Suppl 3), S35–S41. https://doi.org/10.12788/fp.0305
Carpenter, David J., Divya Natesan, R Warren Floyd, Taofik Oyekunle, Donna Niedzwiecki, Laura Waters, Devon Godfrey, et al. “Impact of Race on Outcomes of High-Risk Patients With Prostate Cancer Treated With Moderately Hypofractionated Radiotherapy in an Equal Access Setting.Fed Pract 39, no. Suppl 3 (August 2022): S35–41. https://doi.org/10.12788/fp.0305.
Carpenter DJ, Natesan D, Floyd RW, Oyekunle T, Niedzwiecki D, Waters L, et al. Impact of Race on Outcomes of High-Risk Patients With Prostate Cancer Treated With Moderately Hypofractionated Radiotherapy in an Equal Access Setting. Fed Pract. 2022 Aug;39(Suppl 3):S35–41.
Carpenter, David J., et al. “Impact of Race on Outcomes of High-Risk Patients With Prostate Cancer Treated With Moderately Hypofractionated Radiotherapy in an Equal Access Setting.Fed Pract, vol. 39, no. Suppl 3, Aug. 2022, pp. S35–41. Pubmed, doi:10.12788/fp.0305.
Carpenter DJ, Natesan D, Floyd RW, Oyekunle T, Niedzwiecki D, Waters L, Godfrey D, Moravan MJ, Bitting RL, Gingrich JR, Lee WR, Salama JK. Impact of Race on Outcomes of High-Risk Patients With Prostate Cancer Treated With Moderately Hypofractionated Radiotherapy in an Equal Access Setting. Fed Pract. 2022 Aug;39(Suppl 3):S35–S41.

Published In

Fed Pract

DOI

ISSN

1078-4497

Publication Date

August 2022

Volume

39

Issue

Suppl 3

Start / End Page

S35 / S41

Location

United States