Long-term outcome of radical radiation therapy for prostatic carcinoma: 1967–1987

• Published in: International journal of radiation oncology, biology, physics Vol. 34; no. 1; pp. 41 - 47
• Main Authors: Hahn, Per, Baral, Edward, Cheang, Mary, Kostyra, Jeri, Roelss, Randall
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 1996; Elsevier
• Subjects: Acid Phosphatase - blood; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma - mortality; Carcinoma - pathology; Carcinoma - radiotherapy; Disease-Free Survival; External beam radiation; Humans; Long-term follow-up; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Nephrology. Urinary tract diseases; Proportional Hazards Models; Prostate cancer; Prostatic Neoplasms - mortality; Prostatic Neoplasms - pathology; Prostatic Neoplasms - radiotherapy; Radiation Injuries - complications; Radiation therapy; Radiotherapy Dosage; Time Factors; Tumors of the urinary system; Urinary tract. Prostate gland; External beam radiation; Long-term follow-up; Radiation therapy; Prostate cancer; Human; Urinary system disease; Prostate disease; Follow up study; Malignant tumor; Radiotherapy; Male genital diseases; Long term; Prostate
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/0360-3016(95)02024-1

Purpose : This study was done to review long-term results of radical radiotherapy for prostate cancer. Methods and Materials : The recors of 674 patients with Stage T1a, T1b, T2a, T2b, T3, and any T,N1,M0 disease, treated with external beam radiotherapy between January 1, 1967 and December 1987, were reviewed. These patients were treated to an average total dose of 66 Gy, with an average fractional dose of 2.05 Gy, using megavoltage. The duration of follow-up for surviving patients ranged from a minimum of 7 years to moe than 20 years. Results : The survival for 151 Stage T1a, T1b patients was 98.5% at 5 years 93.6% at 10 years, and 75.2% at 15 years. Survival for 346 Stage T2a,b patients was 87.3% at 5 years, 54% at 10 years, and 26.6% at 15 years. The survival for 92 Stage T3 patients was 87.3% at 5 years, 54% at 10 years, and 26.6% at 15 years. At 15 years, 75.2% of Stage T1a,b patients, 41.5% of Stage T2a,b patients, 21.7% of Stage T3 patients, and 8.5% of Stage T,N1,M0 patients remained free of local recurrence and distant metastases. The elevation of prostatic acid phosphatase prior to radiotherapy was an unfavorable prognostic factor, with impact on both loco-regional recurrences and survival. Conclusions : The external beam radiotherapy for localized carcinoma of the prostate produced a good loco-regional control, NED, and overall survival. Patients with smaller tumors and low grade fared better than the ones with more aggressive and/or bulky tumors. The weakness of this study is the absence of serial prostate-specific measurements, which were not available during the period under study. The complication rate requiring surgical intervention was low, i.e. 0.4%.