Radiotherapy of prostate carcinoma: results of treatment and complications

During October 1974 and December 1981, 204 patients with a localized prostate carcinoma were treated by radiotherapy. One hundred and eighty two patients were suitable for this evaluation. The minimal time of follow-up was 30 months, the mean time 54 months. All patients had a split-course radiotherapy starting by equally weighted opposed pelvic fields with daily doses between 1.8 and 2 Gy, a rest period of 6-7 days and a total dose between 60 and 70 Gy. The overall survival rates (actuarial) for all patients were 64% after 5 years and 55% after 8 years. Several prognostic factors were evaluated. The main factor was tumor grading, the 5 year survival rates fall off from 81% for G1, 65% for G2 to 40% for G3. Split according to T-categories, 5 year survival rates were 73% in T1, 74% in T2, 59% in T3, and 50% in T4. When using the American staging system, we found 75% in stage B and 59% in stage C. There was no statistically significant influence of age and dose on survival, but a clear trend for better survival with higher doses. 36.8% of all patients relapsed, 79% of them developed only distant metastases. Comparing grading and appearance of distant metastases, we found 58% in the group of G3 tumors. There was no influence of transurethral resection (TUR) on survival. Side effects were observed frequently, but mostly mild and transient, late effects were rare.