20 YEARS FOLLOW-UP OF PATIENTS WITH INOPERABLE CANCER OF THE PROSTATE(STAGE-C) TREATED BY RADIOTHERAPY - REPORT OF A NATIONAL COOPERATIVE STUDY

Purpose: To evaluate the longevity and curability of patients with ino perable, Stage C, carcinomas of the prostate by means of external pelv ic irradiation. Methods and Materials: 372 patients, averaging 61 year s of age, with histologically proven adenocarcinoma of the prostate, S tage C, received radiotherapy as part of a National Research Study, fr om 1967 to 1973. Treatments were administered in accordance with a str ict protocol. Portals of entry were optional but it was required that the total dose received at the center of the prostate should be no les s than 7000 cGy in no less than 47 days or 7500 cGy in 54 days. Result s: 245 of the 372 patients survived 5 years without evidence of recurr ence or metastases; 142 were living after 10 years, 64 after 15 years, and 24 after 20 years. A total of 167 patients (44%) survived for yea rs and died from intercurrent diseases without evidence of prostatic c ancer. A total of 177 patients (47%) died of prostatic cancer in decre asing proportions in the years after treatment. Mild episodes of hemat uria and of rectal bleeding were recorded in a number of patients; ure thral and rectal strictured occurred following cystitis and proctitis but no life-threatening complications occurred. Conclusions: Adequatel y fractionated external pelvic irradiation can eradicate inoperable in trapelvic prostatic cancer. A simple statement of survival would disre gard the fact that these elderly patients may be cured of cancer and y et may die of intercurrent diseases proper of their age. Also, it may be expected that a number of patients with Stage C may have unsuspecte d subclinical bone metastases when first seen and that death from meta stases is not necessarily a reflection on the effectiveness of the reg ional treatment.