Carcinoma of the Prostate: Local Control with External Beam Radiation Therapy

Abstract

Local clinical control of the primary disease was evaluated in 209 patients with stage C adenocarcinoma of the prostate treated with definitive external beam radiation therapy and followed for a minimum of 2 years. Of these patients 92 per cent required no further prostatic operations for obstruction. Prostatectomy before therapy did not necessarily prevent later prostatic obstruction from occurring. Of 129 patients who had only a needle biopsy before irradiation 90 per cent had improvement of the obstructive and/or irritative symptoms as tumor regression occurred with therapy and these patients did not require a later prostatic operation for obstruction. Stricture formation occurred in 8 per cent of the patients and was not influenced by the type of preirradiation prostatic operation done. If transurethral resection was reuqired after irradiation it was technically more difficult but the morbidity was acceptable. The incidence of hematuria and incontinence was far less than that reported in non-irradiated patients with this disease. Most tumors exhibited a down-grading effect after irradiation. There were no deaths attributable to the treatment. Over-all, 83 per cent of the 209 patients had no urinary complaints after completion of therapy. From a urological viewpoint, good clinical local control is achieved in the patient with stage C adenocarcinoma of the prostate treated with external beam radiation therapy.

Combination therapy in stage C and D prostatic cancer: rationale and five-year clinical experience

“…The goal of therapy in stage C prostate cancer is local control of the tumor and prolongation of the interval free of disease [65,66]. The present data show that local control of the disease was achieved rapidly in all except one patient (98.6%).…”

Anastomotic Stricture after Radical Prostatectomy

“…It is remarkable that the incidence of subvesical obstruction by urethral strictures is 5–9% after transurethral resection of benign prostatic hyperplasia [8, 9], 8–19% after percutaneous radiation of prostate cancer [10, 11, 12, 13, 14] and 57% after antiandrogen (estrogen) therapy of prostatic cancer [15]. …”

Brachytherapy for advanced prostate cancer bleeding

“…Gibbons et al 17 in their study confirmed that prostate cancer patients who had been treated with curative external beam radiotherapy (EBRT) were less likely to suffer haematuria, 2 years following treatment, than the untreated patients. However, patients who have had previous EBRT are unable to have any further radiotherapy due to the high risk of significant localized tissue damage.…”