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Author: Akakura, K.; Furuya, Y.; Suzuki, H.; Komiya, A.; Ichikawa, T.;
Igarashi, T.; Tanaka, M.; Murakami, S.; Ito, H.
Year: 1999
Title: External beam radiation monotherapy for prostate cancer
Journal: Int J Urol
Volume: 6
Issue: 8
Pages: 408-13
Label: 99394329
Keywords: Adenocarcinoma/diagnosis/mortality/*radiotherapy/secondary/surgery
Aged
Aged, 80 and over
Disease-Free Survival
Follow-Up Studies
Human
Lymph Node Excision
Male
Middle Age
Neoplasm Recurrence, Local
Neoplasm Staging
Prognosis
Prostatic Neoplasms/diagnosis/mortality/*radiotherapy/surgery
Survival Rate
Treatment Outcome
Abstract: BACKGROUND: To clarify the implications and limitations of external
beam radiation monotherapy for localized prostate cancer, the
long-term outcomes and prognostic factors were investigated. METHODS:
Between 1976 and 1994, 91 patients with untreated prostate cancer
were treated with external beam radiation therapy alone. Thirty-two
were classified as T1b, eight were T2a, four were T2b and 47 were
T3. Pelvic lymphadenectomy was carried out in 69 cases; 57 were
staged as pN0, eight were pN1, four were pN2 and 22 were pNX.
Linac X-rays were used in 55 cases, fast neutron in 15 and a combination
of the two in 21. No other therapy was given until relapse and
when relapse was evident endocrine therapy was started. RESULTS:
The observation period ranged from 3 to 206 months with a median
of 78 months. Local control rate and disease-free, cause-specific
and overall survivals at 10 years were 74.0, 49.6, 74.2 and 39.2%,
respectively. By univariate analysis, T category, pN category
and histologic grade were significant prognostic indicators for
disease-free survival. Multivariate analysis revealed that T category
was an independent prognostic factor. In T2b and T3 diseases,
pN0/1 patients demonstrated significantly better disease-free
survival than pNX. CONCLUSIONS: A favorable long-term outcome
was achieved by external beam radiation monotherapy in patients
with minimally extended prostate cancer (T1b and T2a). For locally
advanced disease (T2b and T3), staging pelvic lymphadenectomy
would be useful for the selection of patients.