[Palliative radiotherapy for local progression of hormone refractory stage D2 prostate cancer]

From 1970 to 1992, 10 patients with hormone refractory stage D2 adenocarcinoma of the prostate presenting themselves with urinary retention and/or gross hematuria were treated by palliative irradiation for local progression at Cancer Institute Hospital. External beam irradiation was delivered to the primary lesion at dose of 38 Gy to one patient and 30 approximately 27 Gy to seven patients. Five of these patients in whom an urethral catheter had been indwelling were able to void without difficulty following the treatment. Of four patients with severe hematuria resulting vesical tamponade, none had hematuria after the treatment. These effect lasted until patients' death or more than 11 months follow-up. In other 2 patients, irradiation had to be discontinued at dose less than 20 Gy because of deteriorated general conditions and no significant effect. Complications of the treatment were minimal. These results indicate that the optimal dose of local palliative irradiation is around 30 Gy. Irradiation is a good choice for palliation of locally progressive hormone refractory prostate cancer in view of its certain and long-lasting effect, low invasiveness and minimal complications. When to institute palliative irradiation is one of the most important question in order to secure a good quality of life for patients. From our experiences, it is our belief that if local progression is symptomatic, palliative irradiation should be initiated as soon as possible.