Prognostic parameters in radiotherapeutic management of localized carcinoma of the prostate

A series of 215 patients with carcinoma of the prostate localized to the pelvis received radical radiotherapy. Treatment results have been correlated with the tumor stage, tumor size defined independently from stage, doses of radiation and histological grade. The following ranges from 2 to 13 years (median 5 years). Local recurrence was observed in 6.6 percent of stage B, 16.1 per cent of stage C and 20 per cent of stage D1 cases. Eighty per cent of the patients with stage B disease, 56 per cent with stage C and 0 per cent with stage D1 survived 5 years free of disease. Tumors less than 2 cm. in diameter were controlled uniformly, while tumors more than 2 cm. in diameter showed an over-all local control rate of about 85 per cent. Increasing size resulted in a higher incidence of distant metastases. A dose of 6,500 rad (180 to 200 rad per day) appears adequate for tumors less than 2 cm. in diameter and stage B tumors, while higher stage tumors require doses of 7,000 rad (180 to 200 rad per day). Most high grade tumors and massive tumors of any grade fail outside the pelvis.