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RESULTS OF EXTERNAL BEAM RADIOTHERAPY IN 448 PATIENTS WITH CLINICALLY LOCALIZED ADENOCARCINOMA OF THE PROSTATE
Author(s) -
Mameghan Hedy,
Fisher Richard,
Mameghan Jill,
Brook Susan
Publication year - 1994
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1994.tb02236.x
Subject(s) - medicine , radiation therapy , external beam radiotherapy , adenocarcinoma , stage (stratigraphy) , grading (engineering) , prostate cancer , radiology , prostate , lymph node , biopsy , survival rate , radiological weapon , nuclear medicine , surgery , cancer , brachytherapy , paleontology , civil engineering , biology , engineering
The results of external beam radiotherapy for clinically localized adenocarcinorna of the prostate in 448 patients treated in the period 1980–90 were reviewed. The average follow up was 4.9 years. The patients were aged 44–87 years (median 69 years) and all had histopathological evidence of adenocarcinoma by needle biopsy or transurethral resection of prostate. The histopathological grading was: 127 G 1 ; 154 G 2 ; 127 G 3 ; 12 G 4 ; 28 G x . Clinical staging according to TNM (American Urological Association) was: 29 T 0 (A2); 4 T 1 (B1); 173 T 2 (B2); 176 T 3 (C1); 63 T 4 (C2); 3 T x . Routine surgical pelvic lymph node staging was not performed but patients had radiological (computerized tomography scan or lymphogram) nodal staging: 350 N 0 ; 22 N 1 ; 12 N 2 ; 64 N x . High energy linear accelerator external beam radiotherapy was given by multiple fields to total doses of 50–70 Gy (median 60 Gy). The majority of patients (307, 69%) was treated by a uniform policy under the care of one radiation oncologist (HM). The rates of local and distant failure at 5 years were 10% (s.e. = 2%) and 42% (s.e. = 3%), respectively. The late complication rate at 5 years was 25% (s.e. = 2%), comprising mild 16%, moderate 7% and severe 1.3%. The 5 year overall survival rate was 64% (s.e. = 2%) and the cancer‐specific survival rate was 74% (s.e. = 3%). Both histological grade and clinical stage were strongly predictive of overall survival and distant failure. Only histological grade was predictive of local failure. Treatment with external beam radiotherapy for this common cancer resulted in survival and disease control rates that compare favourably with other published radiotherapy series and has been accompanied by acceptably low morbidity.