Split course pelvic irradiation and a boost for carcinoma of the prostate

Fifty nine patients with prostatic cancer treated by definitive external irradiation were retrospectively evaluated. The true pelvis and prostate gland were irradiated by a split course technique for 48-50 Gy and 68-70 Gy in 7 weeks with a booster dose of 20 Gy delivered in the rest period (after 24-26 Gy) to the prostate via small ports. The overall 3 and 5 year actuarial survival was 83% and 75%, respectively. Only four patients had persistent local disease and two of these (Stage D) died with local disease and distant metastases. Acute mild diarrhea or mild cystitis occurred in 26 patients whereas two patients developed chronic diarrhea lasting for 2 and 12 months after therapy. There were no long-term complications requiring interventional surgery. Sexual potency did not seem to be affected. These results indicate that carefully performed external radiotherapy with a booster dose delivered half-way through whole pelvic radiation is very well tolerated without affecting the local control rate.