Prostate cancer: results of radiotherapy in French cancer institutes
Allain, Y.M.; Bolla, M.; Brune, D.; Castelain, B.; Cellier, P.; Cuillere, J.C.; Douchez, J.; Geslin, J.; Hay, M.; Heintz, J.
Progress in Clinical and Biological Research 243b: 121-139
1987
ISSN/ISBN: 0361-7742 PMID: 3659016 Document Number: 304961
Results are reported of the use of radiotherapy alone in 1010 patients with adenocarcinoma of prostate treated in 15 french cancer units between 1975 and 1982. Mean age of patients was 66 years, and the cancer, graded in 80% of cases: stage I-45%, II:18%, III:11%, IV:5%. Distribution by stage was:Al:4%, A2:6%; B1:12%, B2:29%; C1:34%, C2:12%; Tx:3%. Lymphography was assessed as normal in 200 patients (65%), doubtful in 45 (15%) and pathologic in 61 (20%). Of the 94 lymphadenectomies carried out 57% were negative. Radiotherapy alone is not the only treatment for local forms of prostate cancer, although results are comparable to those of radical surgery and intestitial curietherapy, and it has the advantage of being applicable to all local and regional forms and of being able to be combined with partial surgery. After positive lymphadenectomy, radiotherapy should be preferred to hormone treatment. Negative lymphadenectomy findings should lead to pelvic plus prostate irradiation, rather than irradiation of prostate bed only, insofar as micro-metastases not removed by curettate can be controlled and enhanced local control of tumor is obtained by the former. Survival curves fail to demonstrate any difference for patients undergoing biopsy prior to radiotherapy or a transurethral resection. Finally, in advanced forms, elevated levels of biologic markers must be allowed for to avoid too aggressive radiotherapy, these high levels being indicative of distant metastases. High energy irradiation has allowed radiotherapy to occupy a current place in the treatment of local and regional forms of cancer of prostate.