EARLY PROSTATE-CANCER - THE NATIONAL RESULTS OF RADIATION TREATMENT FROM THE PATTERNS OF CARE AND RADIATION-THERAPY ONCOLOGY GROUP STUDIES WITH PROSPECTS FOR IMPROVEMENT WITH CONFORMAL RADIATION AND ADJUVANT ANDROGEN DEPRIVATION

Long-term outcome of the Patterns of Care Study and the Radiation Ther apy Oncology Group are used to demonstrate the national average result s of treating early prostate cancer in the United States. A group of p atients with stage T1B2 disease and pathologically negative lymph node s showed excellent 10-year survival rates and freedom from clinical ev idence of disease, while prostate specific antigen (PSA) correlations in 10-year survivors indicate that 88% were clinically free of cancer and had a PSA level of less than 4.0 mg./nl., and 65% had a PSA level of less than 1.5 ng./ml. The latter group represented clinical and bio chemical cures. The improvement noted in outcome of locally advanced p rostate cancer treatment by Radiation Therapy Oncology Group prospecti ve trials combining androgen deprivation and radiation therapy is pres ented. These trials will be extended to the poor prognosis group with stage T1,2 disease. The advantages of conformal therapy in acute and l ate morbidity are illustrated with preliminary evidence of improved PS A response as a result of improved technique and higher dose associate d with conformal 3-dimensional treatment.