The results of primary radiation therapy in the management of squamous cell carcinoma of the penis

McLean, Michael; Akl, Ahmed M.; Wards, Padraig; Bissett, Randall; Panzarella, Tony; Gospodarowicz, Mary K.

doi:10.1016/0360-3016(93)90008-j

Cited by 90 publications

(40 citation statements)

References 18 publications

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“…The physical set-up consisted of a rectangular wax block placed around the shaft of the penis to achieve a uniform dose distribution according to the Toronto technique [20].…”

Section: Methodsmentioning

confidence: 99%

Radiation therapy alone or combined surgery and radiation therapy in squamous-cell carcinoma of the penis?

Zouhair

Coucke

Jeanneret

et al. 2001

European Journal of Cancer

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To assess the prognostic factors and the outcome in patients with squamous-cell carcinoma of the penis, a retrospective review of 41 consecutive patients with non-metastatic invasive carcinoma of the penis, treated between 1962 and 1994, was performed. The median age was 59 years (range: 35±76 years). According to the International Union Against Cancer (UICC) 1997 classi®cation, there were 12 (29%) T1, 24 (59%) T2, 4 (10%) T3 and 1 TX (2%) tumours. The N-classi®cation was distributed as follows: 29 (71%) patients with N0, 8 (20%) with N1, 3 (7%) with N2 and 1 (2%) with N3. Forty-four per cent (n=18) of the patients underwent surgery: partial penectomy with (n=4) or without (n=12) lymph node dissection, or total penectomy with (n=1) or without (n=1) lymph node dissection. 23 patients were treated with radiation therapy alone, and all but 4 of the patients who were operated upon received postoperative radiation therapy (n=14). The median follow-up period was 70 months (range 20±331 months). In a median period of 12 months (range 5±139 months), 63% (n=26) of the patients relapsed (local in 18, locoregional in 2, regional in 3 and distant in 3). Local failure (stump in the operated patients, and the tumour bed in those treated with primary radiation therapy) was observed in 4 out of 16 (25%) patients treated with partial penectomy AEpostoperative radiotherapy versus 14 out of 23 (61%) treated with primary radiotherapy (P=0.06). 15 (83%) out of 18 local failures were successfully salvaged with surgery. In all patients, 5-and 10-year survival rates were 57% (95% con®dence interval (CI), 41±73%) and 38% (95% CI, 21± 55%), respectively. The 5-year local and locoregional rates were 57% (95% CI, 41±73%) and 48% (95% CI, 32±64%), respectively. In patients treated with primary radiotherapy, 5-and 10-year probabilities of surviving with penis preservation were 36% (95% CI, 22±50%) and 18% (95% CI, 2±34%), respectively. In multivariate analyses, survival was signi®cantly in¯uenced by the N-classi®-cation, and surgery was the only independent factor predicting the locoregional control. We conclude that, in patients with squamous-cell carcinoma of the penis, local control is better in patients treated with surgery. However, there seems to be no di erence in terms of survival between patients treated by surgery and those treated by primary radiotherapy AEsalvage surgery, with 39% having organ preservation. #

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“…The physical set-up consisted of a rectangular wax block placed around the shaft of the penis to achieve a uniform dose distribution according to the Toronto technique [20].…”

Section: Methodsmentioning

confidence: 99%

Radiation therapy alone or combined surgery and radiation therapy in squamous-cell carcinoma of the penis?

Zouhair

Coucke

Jeanneret

et al. 2001

European Journal of Cancer

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“…2 Radiotherapy is usually indicated when patients do not wish to have their penis removed. [3][4][5] However, it is also considered in the patients who have the disease in regionally advanced stage and in whom, ac-cording to the urologist's estimates, the tumour is inoperable, or the resection of the enlarged lymph nodes was not radical, or post-lymphadenectomy recurrence is diagnosed. The data on what treatment results can be expected in these patients are very scarce.…”

Section: Introductionmentioning

confidence: 99%

Irradiation of regionally advanced carcinoma of the penis

Kragelj¹

2009

Radiology and Oncology

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“…commonly used for T1 or T2 disease measuring <4 cm [68][69][70] as either external beam radiation or brachytherapy. Penile preservation after primary external beam radiotherapy was evaluated by McLean and colleagues.…”

Section: Recommendationsmentioning

confidence: 99%

“…Penile preservation after primary external beam radiotherapy was evaluated by McLean and colleagues. 68 Patients stage T1-2 N0, received external beam radiation to the primary tumour with or without radiation to the regional lymph nodes, leaving surgery for salvage upon relapse. Local control rate was 62% and the penile preservation rate was 66%.…”

Section: Recommendationsmentioning

confidence: 99%

“…Patients who underwent salvage penectomy remained disease-free. 68 More recent data demonstrate an 88% 5-year survival rate with external beam radiotherapy, with inferior local control compared to penectomy. 71 Superior local control is achieved using brachytherapy, with 5-year penile preservation rates of 70% to 88% and 10-year penile preservation rates of 67% to 72% (Level of evidence 2b).…”

Section: Recommendationsmentioning

confidence: 99%

See 1 more Smart Citation

Management of carcinoma of the penis: Consensus statement from the Canadian Association of Genitourinary Medical Oncologists (CAGMO)

Richter

Ruether

Wood

et al. 2013

CUAJ

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The results of primary radiation therapy in the management of squamous cell carcinoma of the penis

Cited by 90 publications

References 18 publications

Radiation therapy alone or combined surgery and radiation therapy in squamous-cell carcinoma of the penis?

Radiation therapy alone or combined surgery and radiation therapy in squamous-cell carcinoma of the penis?

Irradiation of regionally advanced carcinoma of the penis

Management of carcinoma of the penis: Consensus statement from the Canadian Association of Genitourinary Medical Oncologists (CAGMO)

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