title: Differences in disease presentation, treatment outcomes, and toxicities in African American patients treated with radiation therapy for prostate cancer.
abstract: OBJECTIVE
  We analyzed differences in disease presentation, outcomes, and toxicities between African American (AA) and White (W) men treated with definitive radiation therapy for their prostate cancer.
  
  
  METHODS
  Three thousand one hundred eighty cases of prostate cancer treated with various radiation modalities at a single institution were reviewed. The cohort consisted of 92% W patients and 8% AA patients. Clinical and pathologic characteristics at presentation, treatment outcomes, and related toxicities were analyzed between the 2 groups. The median follow-up was 6.6 years (0.6 to 22.4 y).
  
  
  RESULTS
  At presentation, AA men were younger (P<0.001) and more likely to have a Gleason score of ≥7 (47.9% vs. 39.2%, P=0.006). No difference in the 5 or 10-year rates of biochemical failure, disease-free survival, or distant metastases were noted. Although there was a trend for improved 10-year overall survival for AA men (65.3% vs. 57.4%, P=0.06), cause-specific survival was significantly improved at 10 years (98.6% vs. 90.6%, P=0.002). Similar findings were seen when controlling for radiation therapy dose, the use of hormonal therapy, and modality of radiation therapy used. Overall, genitourinary/gastrointestinal toxicities were similar regardless of the modality used.
  
  
  CONCLUSIONS
  Despite differences in presenting characteristics, AA men did not have inferior clinical outcomes but rather improved cause-specific survival when treated with standard of care radiation therapy. Regardless of the treatment modality used, toxicities between AA and W men were comparable.
authors.affiliation: Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
authors.forename: Chirag
authors.initials: C
authors.lastname: Shah
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Jones
authors.forename: Michelle
authors.initials: M
authors.lastname: Wallace
authors.forename: Larry L
authors.initials: LL
authors.lastname: Kestin
authors.forename: Mihai
authors.initials: M
authors.lastname: Ghilezan
authors.forename: Monty
authors.initials: M
authors.lastname: Fakhouri
authors.forename: Ishmael
authors.initials: I
authors.lastname: Jaiyesimi
authors.forename: Hong
authors.initials: H
authors.lastname: Ye
authors.forename: Alvaro
authors.initials: A
authors.lastname: Martinez
authors.forename: Frank
authors.initials: F
authors.lastname: Vicini
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects; D016009:Chi-Square Distribution; D003967:Diarrhea / Q000209:etiology; D018572:Disease-Free Survival; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D010146:Pain / Q000209:etiology; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012002:Rectal Diseases / Q000209:etiology; D012007:Rectum; D012189:Retrospective Studies; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000209:etiology; D014555:Urination Disorders / Q000209:etiology; D044465:White People
chemical_list: D017430:Prostate-Specific Antigen