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At least 19 recordsLinked to original sources
PubMed1992

[Prostatic carcinoma: the importance of echographic monitoring of gland volume after radiotherapy].

Prostatic volume modifications were retrospectively analyzed by means of serial endorectal US in 50 patients affected with prostatic adenocarcinoma previously submitted to external radiotherapy. A progressive reduction in glandular volume (of low, medium, and high grade) was observed in 48/50 patients respectively within 3 months, between 3 and 6 months, and 6-9 months after treatment. After 9 months only lesser modifications were observed. A statistically significant correlation (p less than 0.05) was found between volume decrease percentage and histologic grading of the tumor, but not with its stage. Within the groups of patients affected with similar-grade neoplasms, a statistically significant difference (p less than 0.05) was observed, relative to the decrease rate of prostatic volume, between the patients with complete response and those with partial or no response. US monitoring of prostatic volume after radiotherapy, if correlated with histologic grading, can yield early predictive elements as to treatment outcome, thus contributing to select non-responsive patients to submit to biopsy and, if necessary, to therapeutic alternatives or combinations. Longer-term studies are needed to prove its effectiveness, to prognostic purposes, in the single patient.

Adenocarcinoma↗
PubMed1992

Late local complications after definitive radiotherapy for prostatic adenocarcinoma.

Definitive radiation treatment of prostatic adenocarcinoma has been reported to produce good long-term local disease control, and distant disease failure is almost always associated with good local palliation. We examined late local complications in patients who died with recurrent prostate cancer after definitive radiotherapy as compared to patients treated with hormonal deprivation alone for advanced disease. Between 1979 and 1989 the tumor registry listed 33 men in whom definitive radiotherapy failed documented by bone scan or biopsy and 54 men who were managed with palliative hormonal therapy for noncurable disease. A complication was defined as a local problem requiring a procedure or hospitalization. Overall 23 of the radiotherapy cases (70%) had a local complication as compared to 16 of the patients (30%) who underwent only hormonal therapy. Local complications after radiotherapy included urethral stricture (10 cases), prostatic obstruction (8), hematuria (4), radiation cystitis (3), ureteral obstruction (2) and rectosigmoid radiation injury (4). Local complications after hormonal therapy consisted of prostatic obstruction (11 cases), ureteral obstruction (3) and hematuria (3). The radiotherapy group had 2 urinary and 2 fecal diversions, and the hormonal therapy group had none. In summary, we found a higher risk of late local complications in patients who had recurrence and died with metastatic prostate cancer after definitive radiotherapy, as compared to patients who only received hormonal therapy. These results question the belief that patients with distant disease in whom radiotherapy fails enjoy good long-term local palliation.

Adenocarcinoma↗
PubMed1992

Radiotherapy for prostate cancer: should the seminal vesicles be considered target?

During radiotherapy for prostate cancer, the ability to predict occult seminal vesicle invasion is important since irradiation of the entire seminal vesicles necessitates enlarging the radiation fields beyond what is usually used to irradiate the prostate gland alone. We analyzed the records of 302 patients with clinical Stage T1 or T2 adenocarcinoma of the prostate treated with radical surgery at Duke University Medical Center between 1970 and 1983. Univariate and multivariate analyses were used to examine the relationship between the risk of occult seminal vesicle involvement (defined herein as histologic involvement of the seminal vesicles not detected by physical or radiologic examination) and the following factors: histologic grade, age, clinical stage, and preoperative acid phosphatase. Among 249 patients with complete information, increasing histologic grade (p < 0.001) and clinical stage (p < 0.04) were found to be the strongest predictors of occult seminal vesicle invasion. Conversely, seminal vesicle invasion was very unusual in well-differentiated T1-T2 tumors (6%). This low risk group represented 28% (70/249) of this patient population. There appears to be a substantial subset of patients with well differentiated T1 or T2 tumors who are at very low risk for occult seminal vesicle involvement and in whom the seminal vesicles can be excluded from the target volume. The reduction in target volume may reduce normal tissue reactions, facilitate dose escalation, and possibly increase local control rates.

Adenocarcinoma↗
PubMed1976

Radiotherapy of prostatic cancer.

The methods of treatment and the general guidelines in the treatment of prostatic cancer are discussed. Emphasis is placed upon treatment planning with the help of ultrasonography and the use of high energy photons.

Aged↗
PubMed1978

Latent residual tumor following external radiotherapy for prostate adenocarcinoma.

Fifty patients with adenocarcinoma of the prostate were treated by external supervoltage radiotherapy. Needle biopsies were obtained at timed intervals after completion of therapy. Six of 17 patients with stages A and B disease and 15 of 33 patients with stage C disease had positive biopsies. In patients biopsied more than 18 months after therapy 15 of 29 (52 per cent) had residual tumors. Of 17 patients biopsied 36 months or more after therapy 10 (59 per cent) had residual tumor. These results suggest that patients with residual tumor 18 months after therapy will not have resolution of the tumor at a future date and represent treatment failure.

Adenocarcinoma↗
PubMed1977

[Curative radiotherapy of prostate carcinoma in localized stages (author's transl)].

The reported results of curative radiotherapy in carcinoma of the prostate are equal to radical surgical techniques. In stage C or T3 where radical surgical procedures are not possible, radiation therapy alone may achieve remarkable survival rates. The side effects and complication rates of radiation therapy are acceptable considering the potential cure. Hormone therapy should be reserved primarily for palliative treatment.

Humans↗
PubMed1990

Prostate-specific antigen. Monitoring the response of carcinoma of the prostate to radiotherapy with a new tumor marker.

The role of prostate-specific antigen (PSA), a sensitive tumor marker for cancer of the prostate, has yet to be defined in patients treated with radiotherapy. To evaluate this, PSA and acid phosphatase (AP) were measured prospectively in 110 sequential patients who presented with locoregional carcinoma of the prostate and in whom radiotherapy was to be definitive treatment. Therapy was divided into the following treatment groups: external-beam radiotherapy alone (EBRT), EBRT with brachytherapy (EBRT + B), and hormone therapy either pre-EBRT or post-EBRT (EBRT + H). All patients have been followed for 1 to 17 months and a total of 521 posttreatment PSA determinations have been made. In 91 of 110 patients (83%) PSA was elevated pretreatment and correlated with clinical stage and subsequent relapse. There was no association with Gleason grade, assigned treatment group, or lymph node involvement. Acid phosphatase was elevated in only 31% of the patients initially and had no predictive value in subsequent failure. Nine patients have developed local and/or distant recurrence. None of the patients who failed had their PSA return to normal whereas 74 of 101 (73%) of the remainder have done so. Levels of PSA that do not return to normal during follow-up probably indicate active disease, often without evidence of clinical relapse. The authors conclude that PSA is a useful tumor marker for monitoring response to radiotherapy and may be a predictor of eventual failure thus identifying patients eligible for early intervention therapy as and when it becomes available.

Acid Phosphatase↗
PubMed1992

Effect of external beam radiotherapy on prostatic carcinoma DNA content as measured by static image cytometry.

Static image cytometry was used to study the effect of radiotherapy on the DNA content of prostatic carcinoma. Feulgen-stained specimens from 50 patients before and after radiotherapy were examined. The DNA index increased significantly after treatment (p less than 0.03), and it occurred equally in those with low (less than 1.5) and high (greater than or equal to 1.5) indices. The level of the initial DNA index was significantly related to the rate of symptomatic progression (p less than 0.05). The initial change in and final DNA indices were not related to survival however. There was a significant increase in Gleason score (p = 0.001) and histological grade (p = 0.01) after irradiation and, when taken individually, the degree of change was related to survival in both, p = 0.05 and 0.004, respectively. As Gleason score, Mayo grade and clinical stage were not independent variables; none of them was related to survival when corrected for the other factors. Thus, DNA content or ploidy, as well as Mayo grade and Gleason score, increases in recurrent tumor after radiotherapy. This may be of importance when considering what treatment to use and how intensively the patients should be followed up.

Actuarial Analysis↗
PubMed1991

[Cancer of the prostate: curative radiotherapy preceded by lymphadenectomy in 20 patients. Follow-up over 10 years].

Twenty patients with prostatic cancer were treated by external beam radiotherapy after ilioobturator lymphadenectomy. The patients could be divided into two groups: Group I: no lymph node invasion and Group II: presence of lymph node metastases. In Group I, only one death was due to cancer and the 6-year survival was 90%. In Group II, 7 deaths were due to cancer and the 6-year survival was 20%. Secondary endocrine treated administered at the time of recurrence appeared to significantly prolong survival in comparison with the stage D1 cancers treated immediately by endocrine therapy.

Aged↗
PubMed1976

[The treatment of locally confined prostatic carcinoma: radiotherapy versus total prostatectomy (author's transl)].

Recent data show that carcinoma of the prostate is not radioresistant. But not all prostatic cancers are radiosensitive. All information available in the literature on histologically proven local destruction of prostatic cancer tissue, all survival data and reported complications after radiation treatment are reviewed and discussed. The results of radical surgical treatment from various authors but mainly from the series of Belt and Schröder are used for comparison. From these data it is evident that total prostatectomy of stage B and C tumors is superior to radiation therapy as far as local eradication of tumor goes. Five- and ten-year actuarial survival rates are about identical for stage B disease but favor total prostatectomy in stage C patients. Sexual impotence, the most important lasting complication of total prostatectomy, is present in 23-47% of patients after radiotherapy. Urinary incontinence is not known after irradiation but reported after surgery. Long term damage of the lower urinary tract, the gastrointestinal system, or the lymphatics was reported in 2-24% of patients after radiotherapy. The indication for radiation treatment in stage D patients is very questionable. Exact surgical staging by iliac and obturator lymphadenectomy is desirable to rule out stage D disease in locally confined tumors. Radiation treatment is indicated in patients who are not willing to undergo surgery, who are unwilling to accept sexual impotence, or who are poor candidates for surgery from other reasons.

Cell Transformation, Neoplastic↗
PubMed1975

Radiation enteritis following radiotherapy for prostatic carcinoma.

Two cases of radiation enteritis and small bowel obstruction are reported following supervoltage radiation therapy for carcinoma of the prostate. The mechanisms of radiation injury to the small bowel and contributing factors are discussed. It is suggested that lymph node staging procedures for carcinoma of the prostate be done extraperitoneally in order to avoid the enhanced sensitivity of small bowel to radiation injury following transperitoneal procedures.

Biopsy, Needle↗