Sociodemographic and clinicopathologic characteristics of patients treated with high dose rate prostate brachytherapy in Nigeria

14 Aug 2024

Abbas A Abdus-Salam, Mutiu A Jimoh, Ayorinde M Folasire, Atara I Ntekim, Olabisi T Ojo, Chiamaka G Ehiedu, Augustine O Takure, Bidemi I Akinlade, Afolabi A Oladeji, Foluke O Sarimiye, Adeniyi A Adenipekun

Introduction: Prostate cancer is the most commonly diagnosed malignancy in adult males. High dose rate brachytherapy (HDRB) recently became available in the country for the management of localized prostate cancer in addition to other treatment modalities. HDRB offers a less invasive option to radical prostatectomy and also has a better side effects profile.

Aim: To report the socio-demographic features of the patients treated with HDRB, the clinicopathologic pattern of their disease and possible predictors of these features.

Methods: A retrospective study of patients with histopathologically confirmed prostate cancer, who had HDRB at the Department of Radiation Oncology, University College Hospital, Ibadan, Nigeria, between July 2020 and 2023 was done. Patients’ socio-demographic and clinicopathologic characteristics were extracted from their treatment records.

Results: A total of 73 patients had HDRB within the period under review. The median age was 66 years (51–78 years). About 40% had prostate cancer diagnosed following routine prostate-specific antigen (PSA) screening. The median screening PSA was 20.5 ng/mL (5.83–75.35 ng/mL). About a quarter (24.7%) were asymptomatic at presentation while frequency (60.3%), nocturia (45.2%) and urgency (35.6%) were the most common symptoms. The median initial PSA was 26.00 ng/mL (5.10–124.50 ng/mL) and the median PSA before brachytherapy was 6.25 ng/mL (0.03–175.30 ng/mL), the majority (75.3%) had androgen deprivation therapy before brachytherapy. Forty-seven patients (64.4%) presented with TNM stages 1 and 2 while grade group 2 (24.7%) and high risk (76.7%) were the commonest grade group and risk group, respectively. There was a significant association between age group and TNM stage (p = 0.043), level of education (LOE) and TNM stage (p = 0.037) as well as PSA screening and grade group (p = 0.007).

Conclusion: The majority of the patients who presented for prostate brachytherapy were elderly, had higher initial PSA, were in the high-risk group and had early-stage disease. About 25% of the patients were asymptomatic at presentation. Patients with tertiary LOE and elderly patients presented more with stage 1 and 2 diseases.

Key words: prostate cancer, PSA, routine screening, high dose rate brachytherapy