title: Curative brachytherapy for prostate cancer in African-Caribbean patients: A retrospective analysis of 370 consecutive cases.
abstract: Prostate cancer is the most frequent malignancy in African-Caribbean men, a population sharing common genetic traits with African-American (AA) but presenting also genomic and epidemiologic specificities. Despite socioeconomic disparities with French mainland, all patients were treated within the French state-financed equal-access health care system. In this study, we report biochemical outcomes of patients treated by brachytherapy in our department from 2005 to 2014 in an African-Caribbean population.
  
  
  
  Three hundred seventy consecutive patients receiving125I brachytherapy as a curative treatment for early-stage (localized) disease between 2005 and 2014 were recorded. Selected patients presented with low-risk disease: initial prostate-specific antigen (PSA) <10 ng/mL, clinical stage ≤ T2c, and Gleason score <7. Patients with intermediate risk of recurrence were also included on a case-to-case basis with prostate-specific antigen <15 or Gleason score 7 (3 + 4). Biochemical failure free-survival was defined according to the American Society for Radiation Oncology nadir+2 definition.
  
  
  
  The 3-year and 5-year biochemical failure free-survival for the entire cohort were 98.3% and 91.6%, respectively. For patients with low- and intermediate-risk disease, the 5-year BBFS rates were 92.1% and 90.8%, respectively. In univariate and multivariate analyses, only Gleason score (<7 vs. 7; p =  0.030 vs. p < 0.05) was a significant predictor of biochemical failure. The overall rate of late and acute Grade 2 or higher genitourinary toxicity was 12.6% and 10.3%.
  
  
  
  In this large single-center series, brachytherapy achieved excellent rates of medium-term biochemical control in both low and selected intermediate-risk localized prostate cancer in African-Caribbean patients. Brachytherapy seems to be an excellent choice of treatment, with excellent outcomes and limited morbidity for African-Caribbean populations.
authors.affiliation: Department of Radiation Oncology, University Hospital of Martinique, Fort-de-France, France. Electronic address: vincentatallah298@hotmail.com.
authors.forename: V
authors.initials: V
authors.lastname: Atallah
authors.affiliation: Department of Radiation Oncology, University Hospital of Martinique, Fort-de-France, France.
authors.forename: N
authors.initials: N
authors.lastname: Leduc
authors.affiliation: Department of Radiation Oncology, University Hospital of Martinique, Fort-de-France, France.
authors.forename: M
authors.initials: M
authors.lastname: Creoff
authors.affiliation: Department of Radiation Oncology, Bergonie Institute, Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Sargos
authors.affiliation: Department of Surgical Urology, University Hospital of Martinique, Fort-de-France, France.
authors.forename: T
authors.initials: T
authors.lastname: Taouil
authors.affiliation: Department of Radiation Oncology, University Hospital of Martinique, Fort-de-France, France.
authors.forename: P
authors.initials: P
authors.lastname: Escarmant
authors.affiliation: Department of Radiation Oncology, University Hospital of Martinique, Fort-de-France, France.
authors.forename: V
authors.initials: V
authors.lastname: Vinh-Hung
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D001918:Brachytherapy / Q000009:adverse effects; D018572:Disease-Free Survival; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008395:Martinique; D008875:Middle Aged; D060787:Neoplasm Grading; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D012307:Risk Factors; D001741:Black or African American
chemical_list: D007457:Iodine Radioisotopes; D017430:Prostate-Specific Antigen
keywords: African-Caribbean; Brachytherapy; Prostate cancer; Racial disparity