RADICAL RADIOTHERAPY FOR LOCALIZED ADENOCARCINOMA OF THE PROSTATE - AREPORT OF 191 CASES

Objective To assess the results of radiotherapy in the treatment of lo calized prostate cancer. End points for assessment were survival, loca l control, development of metastases, and the toxicity of therapy. Mat erials and methods The case notes of 191 patients who were treated wit h radical radiotherapy between 1982 and 1992 were reviewed. The pathol ogy of 130 patients was reviewed by a single pathologist. A multivaria te analysis was performed to identify significant prognostic factors w ith regard to survival and relapse. Results One-hundred and eighty-two patients were assessable. The minimum length of follow-up was one yea r (median=40 months). The actuarial cause-specific 5 and 10 year survi val rates were 63% and 35% respectively. Local progression occurred in 41% of patients with 37% developing metastases. Multivariate statisti cal analysis demonstrated that T stage and Gleason Score were signific ant predictors for survival. Late complications were usually mild, wit h only 4% developing serious bladder toxicity. Conclusion Radical radi otherapy has a role in the curative treatment of prostate cancer. Surv ival is significantly related to T stage at the time of presentation, and to the Gleason Score of the tumour. Survival in this series was no t as good as the best surgical series, but it is still not clear which patients should receive radiotherapy and which surgery as their prima ry management.