ROLE OF RADIATION-THERAPY IN THE TREATMENT OF CARCINOMA OF THE PENIS

Objective To study the effectiveness of radiation therapy (RT) for the primary tumour and for groin node and distant metastases in patients with squamous cell carcinoma of the penis. Subjects and methods Betwee n January 1959 and June 1988, 156 patients with negative lymph nodes i n the groin underwent RT of the primary tumour. RT was also administer ed to 120 patients with lymph node involvement in the groin and to nin e with distant metastases. Results Local control of the primary tumour was achieved in 65% of patients with RT alone and in another 33% with salvage surgery. Lymph node recurrence in the groin was seen in 11% o f patients and the corrected 5-year disease-free survival was 87%. Pre -operative inguinal RT was useful in patients with mobile lymph nodes greater than or equal to 4 cm in size in the groin, with only 8% of su ch lymphadenectomy specimens showing perinodal infiltration and only 3 % of such patients having post-operative groin recurrences. Pelvic and /or para-aortic RT was ineffective in patients with pelvic node metast ases. Palliative RT resulted in amelioration of symptoms in 56% of pat ients with fixed lymph nodes in the groin, all five patients with pain ful bony metastases and one of two patients with cord compression and paraplegia. Conclusion Radiation therapy is ideal for patients with T1 and T2 primary cancers of the penis. Pre-operative RT is useful for p atients with mobile lymph nodes greater than or equal to 4 cm in size in the groin. RT provides effective palliation in patients with advanc ed regional disease and/or distant metastases.