The value of extended field radiation therapy in carcinoma of the prostate

Since 1970, a total of 342 patients have received radical radiation therapy for carcinoma of the prostate. The estimated 5 year survival of 78% and 5 year disease-free survival of 67% remains unchanged. Initially, all patients received radiation therapy to the prostate. Recently, patients with more advanced disease as well as a selected group of patients with less extensive disease received extended field radiation to the pelvis. comparison of these two groups of patients shows no advantage for extended field radiation in early stage disease. However, in more advanced disease patients with involvement of more than one lobe or extraprostatic extension], there is evidence that extended field radiation improves the disease-free survival of these patients 63% for 5 year disease free for extended field radiation versus 35% for localized radiation]. This difference persists irrespective of method of diagnosis. While this study is non-randomized, the results were obtained during a period when there has been no other change in treatment philosophy. The results will require confirmation on a randomized trial basis.