Prostatic cancer treated by external irradiation at the Rotterdam Radiotherapy Institute

Two-hundred-seventy-nine patients, mainly with prostatic cancer category T3NXM0 and T4NXM0 , have been treated by a full-course of external irradiation. Five- and 10-year survivals and relapse-free survivals are comparable to reports in literature. Complications in about 24% of all cases are acceptable but might be reduced in future by more sophisticated techniques. Important prognostic factors were the T-category of the primary, the histological grade according to WHO and according to Gleason, and to a lesser extent vascular invasion in the biopsy specimen and the diagnostic procedure: either transurethral resection or needle biopsy. Combinations of WHO-grade, Gleason-grade and T-category are possibly the best prognosticators . Persisting, positive transrectal cytology after the irradiation is probably an indicator of a slightly increased risk of metastasis. In spite of hormone therapy after evidence of metastasis, prognosis is poor and not significantly influenced by any pre-irradiation prognosticator.