Definitive Radiation Therapy for Prostatio Carcinoma: Mayo Clinic Experience

Abstract

Primary radiation therapy for clinically localized prostatic cancer is effective and safe. Of 147 patients treated between 1964 and 1973, 144 were evaluated 5 yr after the initial date of radiation therapy. At 5 yr the overall survival rate was 80%; the rate of survival free of disease was 63%. Of the patients > 70% were free of progression in 5 yr after the date of the 1st radiation treatment. Analysis revealed a highly significant association between tumor grade and patient survival (P < 0.001), and between tumor grade and the interval free of disease (P < 0.002). The relationship between tumor stage and time to progression of disease also was significant (P approximately equal to 0.01), but there was no relationship between lower stage and longer survival. Of 142 patients who completed treatment only 20 (14%) had local recurrence of the prostatic cancer after radiation therapy, representing a local control rate of 86% 5 yr after treatment. A few patients underwent posttreatment prostatic biopsy after radiation therapy. If a biopsy is done for increased prostatic induration and the results are positive, adjuvant treatment is recommended. In the absence of urologic symptoms or progressive induration of the prostate gland, biopsy is not instrumental in predicting the course of the cancer.