Carcinoma of the penis: a retrospective review of treatment with iridium mould and external beam irradiation.

This paper is a retrospective review of the treatment of carcinoma of the penis with radiotherapy alone over a 30-year period from 1960-1990 at The Royal London Hospital. During that time, 44 patients aged 31-85 years (mean 63) underwent treatment in our department, all of whom had histologically proven squamous carcinoma. Patients initially treated by surgery and those treated with combined surgery and radiotherapy were excluded from analysis. Twenty-four patients were treated by an iridium mould, and 20 by external beam irradiation. There were 67% complete responses; 79% for the patients treated by an iridium mould, 53% for those treated by external beam irradiation, although this difference between the two treatment groups was due to a more favourable stage distribution in the iridium group. Actuarial 2-, 5- and 10-year overall survivals were 87.9%, 85.1% and 72.3% respectively, with no significant difference between the iridium and external beam groups. For Stage I patients, the response rates and actuarial penile disease free survivals were comparable for the iridium and external beam groups. Urethral stricture was recorded in 10% of those treated by external beam irradiation and 13% of those treated by iridium mould. These results confirm that conservative treatment of carcinoma of the penis with radical radiotherapy allows preservation of a functioning penis with acceptable morbidity and a high proportion of long term survivors when surgery is used for salvage of locoregional relapse.(ABSTRACT TRUNCATED AT 250 WORDS)