Radiotherapy for local progression in patients with hormone-refractory prostate cancer

PURPOSE: The aim of the present study was to investigate the effect of radiotherapy on the local progression of hormone-refractory prostate cancer. METHODS: From 1986 to 1995, 38 patients were diagnosed with local progression without distant progression after hormonal therapy at Chiba University Hospital. Eleven cases were treated with irradiation for local progression. External beam irradiation was delivered to the prostate at a dose of 50-66.6 Gy. RESULTS: In patients treated with radiotherapy, the duration from initial treatment to local recurrence was 6-80 months (mean +/- SD: 33.9 +/- 22.9 months). The follow-up period after irradiation was 7-64 months (mean +/- SD; 25.4 +/- 18.8 months). Three and 5 year cause-specific survival rates from radiotherapy were 46.2 and 23.1%, respectively. Radiotherapy had a marked effect on symptoms associated with local progression and no patients suffered from the symptoms after the radiotherapy. Complications of radiotherapy were limited. CONCLUSIONS: In patients with hormone refractory local progression without distant progression, low morbidity, low mortality radiotherapy offers a variable therapy to other palliative treatments because radiotherapy is able to control local symptoms for a long period of time.     

Prognosis of patients with T4 prostate carcinoma

BACKGROUND: The clinical course of patients with T4 prostate carcinoma was examined in order to consider whether there are alternative treatment options besides androgen ablation therapy. METHODS: From 1986 to 1995 at Chiba University Hospital, there were 22 cases of T4 prostate carcinoma. Sixteen cases had no bone metastasis at initial diagnosis. Tumor grade and response of prostate-specific antigen (PSA) to endocrine treatment were evaluated in these 16 cases. RESULTS: Four patients had moderately differentiated and 12 had poorly differentiated adenocarcinoma. For initial treatment, all patients received endocrine therapy. Anti-androgen therapy was effective in 15 cases and the 5 year cause-specific and progression-free survival rates were 72.1 and 38.1%, respectively. Patients with moderately differentiated tumors tended to have a longer disease-free period than those with poorly differentiated tumors (P = 0.047). CONCLUSIONS: Endocrine therapy was effective in patients with T4 tumors. It was suggested that aggressive local treatment (i.e. radiotherapy) in combination with endocrine therapy may be considered if the patients had no distant metastases and had a long life expectancy.