Radiation therapy in adenocarcinoma of the prostate with pelvic lymph node involvement on lymphadenectomy

Batata, M.A.; Hilaris, Basil S.; Chu, Florence C. H.; Whitmore, Willet F.; Song, Hong; Kim, Y.; Horowitz, B.; Song, Kounn Sik

doi:10.1016/0360-3016(80)90030-9

Cited by 33 publications

(3 citation statements)

References 4 publications

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“…A number of studies have yielded long-term survival data for patients treated with megavoltage photon irradiation for these presentations, and appear to favor this approach [2-61. Other investigators have presented data to support the thesis that photon irradiation does not substantially alter the natural history of the diseases in this same group of patients [7,8].…”

Section: Introductionmentioning

confidence: 83%

Eight years experience with neutron radiotherapy in the treatment of stages C and D prostate cancer: Updated results of the RTOG 7704 randomized clinical trial

Russell¹,

Laramore²,

Krall

et al. 1987

The Prostate

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The records of 91 patients enrolled between June 1977 and April 1983 in the Radiation Therapy Oncology Group (RTOG) randomized study investigating fast neutron radiation therapy in the treatment of locally advanced prostate cancer were reviewed. Patients with stages C and D1 adenocarcinoma were randomized to receive either combined fast neutron and photon irradiation (mixed-beam) or conventional photon irradiation alone. Survival (actuarial) at eight years for the mixed-beam cohort was 63% vs 13% for the patients receiving photons alone (P = .01). Corresponding "determinental" survival rates, adjusted by exclusion of intercurrent deaths, were 82% and 54%, respectively (P = .02). Freedom from locally recurrent prostate cancer was 77% for mixed-beam patients and 31% for patients receiving photons alone (P less than .01). Analyses of outcomes accounting for all major prognostic determinants confirm the greater efficacy of mixed beam treatment with P less than .05 for survival, determinental survival, and local control.

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Section: Introductionmentioning

confidence: 83%

Eight years experience with neutron radiotherapy in the treatment of stages C and D prostate cancer: Updated results of the RTOG 7704 randomized clinical trial

Russell¹,

Laramore²,

Krall

et al. 1987

The Prostate

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“…A possible explanation for the reported results in stage D1 seems that local retropubic '251 implantation is not able to impact the time of progression in nodal positive disease. The authors present data of 21 patients with pelvic RT compared to 196 patients without RT, which, in part, has been previously published [23]. There was no benefit for patients with pelvic RT in producing a distant metastasesfree survival.…”

Section: Discussionmentioning

confidence: 91%

Influence of the extent of nodal involvement on the outcome in stage D1 prostate cancer

Wiegel

1994

Radation Oncology Invest

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SUMMARY From 1975 to 1991, 82 patients with pathological stage D1 prostate cancer underwent radiation therapy. Twelve patients were excluded from analysis because treatment started when local tumor progression was determined. Of the 70 remaining patients, 30 initially had a radical prostatectomy with orchiectomy and 40 patients had only a biopsy with orchiectomy. All patients had an additional androgen blocking. Sixty-seven of 70 patients were treated with photons up to a total dose of 4,00O-5,000 cGy to the small pelvis and 55 of 67 received an additional boost to the prostatic region to deliver 6,000-7,000 cGy. In 12 cases, 14 MeV fast neutrons were used for the boost. Three patients underwent only irradiation of the prostate. With a median follow up of 58 months (range: 3-183 months), the overall survival rate (0s) for 5 and 10 years was 78% and 45%, respectively.The cause-specific survival rate was 86% and 69% for 5 and 10 years, respectively. Thirteen patients with one microscopically positive node (group I) had an 0s of 90% and 68% (5 and 10 years, respectively) compared to 57 patients with one or more microscopically positive nodes (group II), who had an 0s of 75% and 40%, respectively (P > 0.05). A significant advantage for patients with microscopically involved nodes was seen in diseasefree survival: 84% vs. 62% for 5 years and 63% vs. 27% for 10 years (€' < 0.05) and in cause specific survival: 100% vs. 82% for 5 years and 100% vs. 59% for 10 years (P < 0.05). Major complications occurred in four patients (6%); all of these were treated following prostatectomy. Prospective randomized clinical trials should compare the results of radiotherapy and hormonal treatment with radical prostatectomy and hormonal treatment and hormonal treatment alone in stage D1 prostate cancer. The treatment of choice remains unclear.

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“…Such low-grade patients usually have a high frequency of regional lymph node metastases, rendering them less suitable for radiotherapy. It is doubtful if pelvic radiotherapy yields any beneficial effect in terms of increased long-term survival ( years) in patients with pelvic lymph node metastases [ 12,131. Some reports indicate an improved survival in patients receiving pelvic radiotherapy, whereas others do not find any difference between patients treated by extensive vs limited pelvic radiation fields [4,14,15].…”

Section: Discussionmentioning

confidence: 99%

Definitive Radiotherapy of Prostatic Cancer: The Norwegian Radium Hospital’s Experience (1976-1982)

1988

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During the years 1976 to 1982 definitive curatively aimed radiotherapy to the primary tumor was given to 53 patients with prostatic cancer confined to the true pelvis (To,2;19; T3,24; Tq,8; No,18; N,,2; N,, 33); all patients were of the Mo-category. The pelvic lymph nodes received a total dose of 2 Gy X 25 by means of an anterior and posterior radiation field. The prostatic gland was irradiated by an additional booster dose of 2 Gy x 10 given to a perineal field. Twenty-four patients have relapsed after their prostatic radiotherapy, only three of them within the irradiated area. For the patients with To-T2 tumors, the 5-year crude survival was 69%, whereas it was only 37% for patients with T3 tumors.Thirty-five patients developed intestinal (26 patients) and/or urogenital (23 patients) radiation side effects. In three patients a colostomy had to be performed owing to rectal stricture or fistula. The poor survival after radiotherapy in the present series is probably due to a high incidence of unrecognized pelvic lymph node metastases. In the future only prostatic cancer patients without pelvic lymph node spread will be considered candidates for definitive radiotherapy. An optimal radiation technique is mandatory in order to avoid major radiotherapy-induced toxicity.

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Radiation therapy in adenocarcinoma of the prostate with pelvic lymph node involvement on lymphadenectomy

Cited by 33 publications

References 4 publications

Eight years experience with neutron radiotherapy in the treatment of stages C and D prostate cancer: Updated results of the RTOG 7704 randomized clinical trial

Eight years experience with neutron radiotherapy in the treatment of stages C and D prostate cancer: Updated results of the RTOG 7704 randomized clinical trial

Influence of the extent of nodal involvement on the outcome in stage D1 prostate cancer

Definitive Radiotherapy of Prostatic Cancer: The Norwegian Radium Hospital’s Experience (1976-1982)

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