[Treatment results with external radiotherapy in prostate cancer].
OBJECTIVE
External irradiation is an accepted curative treatment modality for patients with localized prostatic tumor. The 15-year results in patients treated by radical irradiation alone are presented. The determinant prognostic factors for local tumor control and disease free survival are analyzed.


METHODS
135 patients with a histologically confirmed localized carcinoma of the prostate were treated at our department from May 1972 to January 1998. Fifty patients received Co-60 therapy; the linear accelerator and high energy photons were utilized in the remaining 80 patients. By tumor stage, 53 patients were B1, 49 B2 and 33 C. The mean follow-up was 61 months (range 1-180). Most patients were exposed to localized fields of irradiation; dose ranged from 50-74 Gy, fractionated at a dose of 180-200 cGy/day.


RESULTS
Overall local tumor control was 77% at 5 years and 73% at 15 years, with a disease free survival of 63% and 45% at 5 and 15 years, respectively. Local tumor control at 13 years was 71% for stage B1, 82% for B2 and 70% for C. The disease free survival at 13 years for stages B1, B2 and C were 46%, 49% and 36%, respectively. The BD and MD tumors had a 15-year disease free survival of 48% vs 32% for the PD tumors (p = 0.005). Patients with PSA < or = 20 ng/ml before treatment showed a disease free survival of 87% vs 48% for those with PSA > 20 ng/ml ((p = 0.011). Multivariate analysis showed dose to be a determinant prognostic factor for local tumor control (0.0432); dose and histological grade were determinants for disease free survival (p = 0.029 and 0.033).


CONCLUSIONS
This retrospective study found dose to be a determinant prognostic factor for local tumor control and both dose and histological grade were determinants for disease free survival. Radiotherapy is a therapeutic option for these patients. The results can be enhanced if the dose delivered to the prostate can be increased while maintaining the complication rate within the same ranges.
Prada Gómez
P J
PJ
Servicio de Oncología-Radioterápica, Hospital Central de Asturias, Oviedo, España.
Alonso García
A
A
Canteli Castañón
M
M
Olay Gayoso
L
L
Alonso Pantiga
R
R
Rijo
G J
GJ
Rodríguez Fernández
R
R
Querejeta Recalde
A
A
Castillo
A F
AF
Matallanas Bermejo
M
M
Fernández García
J
J
Vivanco Parellada
J
J
D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D003037:Cobalt Radioisotopes / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011867:Radioisotope Teletherapy / Q000009:adverse effects; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
D003037:Cobalt Radioisotopes