Beaud Conrad Mabika Ndjembidouma 1
1Akanda Cancer Institute, Libreville, Gabon
Background: This research presents a comprehensive retrospective analysis (2013-2021) of clinical and dosimetric outcomes of 3D Conformal Radiation Therapy (3D-CRT) for prostate cancer at the Akanda Cancer Institute (Gabon). The objective was to identify risk factors for acute and late gastrointestinal (GI) and genitourinary (GU) toxicities, graded according to CTCAE v4.0.
Methods: Data from 46 patients (doses 66–80 Gy) were analyzed. The study utilized statistical tests (Mann-Whitney, Pearson/Spearman) and binary logistic regression models (univariate and multivariate) to correlate clinical parameters (age, comorbidities, history) and dosimetric parameters from Dose-Volume Histograms (DVH) with the occurrence of complications.
Key Results:
- Genitourinary (GU) Toxicities: Regression analysis identified prostate volume (p = 0.0423) and the clinical prostate volume irradiated at the prescribed dose (p = 0.029) as predictors of acute GU toxicity. Hypertension (p = 0.039) and the presence of acute toxicities were predictive of late GU toxicities.
- Gastrointestinal (GI) Toxicities: A significant correlation was established between late rectal toxicity and the rectal volume irradiated at the prescribed dose (p = 0.02).
- Clinical Efficacy: Despite high radiation doses, the protocol demonstrated exceptional oncological efficacy, with a 100% survival rate observed during the follow-up period (median 57.5 months).
Conclusion: This work validates the safety and efficacy of 3D-CRT in Gabon. It provides medical physicists with the first robust toxicity predictors adapted to the local context, enabling proactive monitoring and optimization of treatment planning in sub-Saharan Africa.
Published Articles related to this PhD:
- Assessment of rectal toxicities after radiation therapy for localized prostate cancer: experience of the Akanda Cancer Institute in Gabon. Reports of Practical Oncology and Radiotherapy (2023). DOI: https://doi.org/10.5603/rpor.97507
- Risk factors for bladder adverse events following radiotherapy for localised and locally advanced prostate cancer in Gabon. Journal of Radiotherapy in Practice (2025). DOI: https://doi.org/10.1017/S1460396925100265