Definitive Radiotherapy of Prostatic Cancer: The Norwegian Radium Hospital’s Experience (1976-1982)

Abstract

During the years 1976 to 1982 definitive curatively aimed radiotherapy to the primary tumor was given to 53 patients with prostatic cancer confined to the true pelvis (To,2;19; T3,24; Tq,8; No,18; N,,2; N,, 33); all patients were of the Mo-category. The pelvic lymph nodes received a total dose of 2 Gy X 25 by means of an anterior and posterior radiation field. The prostatic gland was irradiated by an additional booster dose of 2 Gy x 10 given to a perineal field. Twenty-four patients have relapsed after their prostatic radiotherapy, only three of them within the irradiated area. For the patients with To-T2 tumors, the 5-year crude survival was 69%, whereas it was only 37% for patients with T3 tumors.Thirty-five patients developed intestinal (26 patients) and/or urogenital (23 patients) radiation side effects. In three patients a colostomy had to be performed owing to rectal stricture or fistula. The poor survival after radiotherapy in the present series is probably due to a high incidence of unrecognized pelvic lymph node metastases. In the future only prostatic cancer patients without pelvic lymph node spread will be considered candidates for definitive radiotherapy. An optimal radiation technique is mandatory in order to avoid major radiotherapy-induced toxicity.