Research Article

COMPARATIVE OUTCOMES OF RADIATION TREATMENT MODALITIES FOR PROSTATE CANCER IN A RESOURCE-LIMITED SETTING

Oladeji Afolabi adebayo1, Ayorinde M. Folasire2*, Foluke O. Sarimiye3, Chiamaka Ehiedu4, Olabisi T. Ojo5
1 Radiation Oncology Department, University College Hospital, Ibadan, Oyo State, Nigeria
2 Department of Radiation Oncology, College of Medicine, University of Ibadan, Nigeria
3 Department of Radiation Oncology, University of Ibadan/University College Hospital (UCH), Ibadan, Oyo State, Nigeria
4 Department of Radiation Oncology, University College Hospital, Ibadan PMB 5116, Nigeria.
5 Department of Radiation Oncology, University of Ibadan/University College Hospital, Ibadan.
* Corresponding author: ayofolayemisi@gmail.com
Published: Feb, 2026
DOI: 10.67579/njo.2026.6thr279i
Pages: 99-112
Views: 292
Downloads: 176

Abstract

Background: Prostate cancer remains a major malignancy in sub-Saharan Africa, where access to advanced radiotherapy is limited.

Objective: This study compares biochemical recurrence-free survival (bRFS) and toxicity outcomes among prostate cancer patients who received external beam radiotherapy (EBRT) alone, high-dose-rate brachytherapy (HDRBT) monotherapy, or combined EBRT+HDRBT at West Africa’s first Prostate HDR brachytherapy centre.

Methods: This retrospective cohort study included 109 prostate cancer patients treated at University College Hospital, Ibadan, Nigeria, from January 2020 to December 2023. Patients were grouped by modality: EBRT alone (n=67), HDRBT monotherapy (n=24), and EBRT+HDR BT (n=18). Biochemical recurrence was defined per Phoenix criteria (nadir PSA+2ng/mL). Toxicity was graded using the Common Terminology Criteria for Adverse Events v5.0. Kaplan-Meier analysis estimated bRFS, with log-rank test for comparisons and multivariable Cox regression for predictors. Logistic regression assessed toxicity predictors. p < 0.05 was denoted as significant.

 

Results: Median follow-up was 21 months (range:6-42 months). Kaplan-Meier estimated bRFS at 30 months was 41.7%, 56.5% and 84.4% for HDRBT, EBRT and EBRT+HDRBT, respectively (p=0.075). Multivariable Cox analysis identified the Gleason score as the only significant predictor (HR=1.34, 95% CI:1.07-1.69; p=0.012). EBRT+BT had better biochemical control compared to EBRT. (HR=0.30, 95% CI:0.09-1.06; p=0.061). ≥Grade 2 toxicity was lower in BT (4.2%) compared to EBRT (35.8%) and EBRT+HDRBT (27.8%; p<0.001), with HDRBT associated with reduced odds (AOR=0.069, 95% CI:0.008-0.609; p=0.016).

 

Conclusion: In this LMIC cohort, combined EBRT+HDRBT showed a non-significant trend toward improved bRFS compared to EBRT alone, and significantly better outcomes than BT monotherapy. HDRBT monotherapy offered the best tolerability.


Keywords

Prostate Cancer; External Beam Radiotherapy; High-Dose-Rate Brachytherapy; Toxicity; Biochemical Recurrence-Free Survival

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How to Cite

adebayo, O. A., Folasire, A. M., Sarimiye, F. O., Ehiedu, C., & Ojo, O. T. (2026). COMPARATIVE OUTCOMES OF RADIATION TREATMENT MODALITIES FOR PROSTATE CANCER IN A RESOURCE-LIMITED SETTING. Nigerian Journal of Oncology, 2(1), 99-112. https://doi.org/10.67579/njo.2026.6thr279i

O. A. adebayo, A. M. Folasire, F. O. Sarimiye, C. Ehiedu, and O. T. Ojo, "COMPARATIVE OUTCOMES OF RADIATION TREATMENT MODALITIES FOR PROSTATE CANCER IN A RESOURCE-LIMITED SETTING," Nigerian Journal of Oncology, vol. 2, no. 1, pp. 99-112, February 2026. doi: 10.67579/njo.2026.6thr279i

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