Comparison of whole pelvis versus small-field radiation therapy for carcinoma of prostate.

One hundred thirty-six patients with adenocarcinoma of the prostate gland Stage A2 (12 patients), Stages B1 and B2 (26), Stage C (64), and Stages D1 and D2 (34 patients) were evaluated clinically and treated in a similar fashion at three hospitals. Megavoltage radiation therapy units were employed to deliver 4,600-5,000 cGy to the whole pelvis, and the prostatic area was treated for an additional 2,000 cGy (boost). Local recurrence was infrequent (8/136 = 6%), and the five-year actuarial survival and disease-free survival rates were 85 and 42 per cent, respectively. Adverse clinical parameters included poor histologic differentiation, age younger than sixty years, and diagnosis by transurethral resection of the prostate rather than needle biopsy in Stage C patients. Severe acute reactions occurred in only 2 patients, and only 2 patients were hospitalized for severe chronic (late) reactions. Whole pelvis radiation yielded a statistically significant improved five-year survival and three-year disease-free survival for similarly evaluated patients for Stage C but not for Stages A and B when compared with 116 patients treated with small-volume radiation (prostate area), previously reported from these three hospitals.