Radiation therapy for carcinoma of the prostate gland: experience at a community hospital

Over an 18-year period, 453 men with carcinoma of the prostate gland were treated with curative intent using radiation therapy alone at one large community hospital in Hawaii. A retrospective analysis of the survival of these men was undertaken in order to compare this experience with that of other investigators. Clinical stage was found to be a less reliable prognostic factor than the histologic grade of the tumor. Patients with poorly differentiated tumors had the worst prognosis with a 5-year survival probability of 48.4%. Patients who were otherwise eligible for prostatectomy (stage B1) had the best prognosis, 88.1% at 5 years. Inability to clearly demarcate stages A2, B2 and C was reflected in similarity of survival probability for all of these patients, 69.3% to 70.5% at 5 years. Finally, a selected group of patients with metastatic disease confined to the pelvis who were treated with curative intent is presented herewith and compared to a much larger group of patients with metastatic disease who were treated palliatively. Survival was equally dismal in both groups. X-ray treatment alone can be applied with curative intent to all patients who have no evidence of metastasis, with substantial hope for local tumor control and significant survival.