The significance of needle biopsy after irradiation for stage c adenocarcinoma of the prostate

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Abstract
The presence or absence of malignant cells in needle biopsy specimens following irradiation for adenocarcinoma of the prostate was used to criticize or defend this treatment. At Walter Reed Medical Center, 38 patients with stage C adenocarcinoma underwent definitive irradiation between Aug., 1970 and March, 1973. The median dose to the pelvis was 7000 rads in 31 fractions in 43 days (2030 ret). Posttreatment examination included palpation of the prostate and transperineal biopsy of the most suspicious areas. Gradual disappearance of the palpable tumor occurred in all patients. Two men had clinical evidence of regrowth of prostatic cancer. Thirty-three patients had up to 7 biopsies each for a total of 139, an average of 4 biopsies/patient. There were 49 positive and 90 negative biopsies. Positive biopsy rate correlated only with the interval after irradiation, 60% at 6 mo., 37% at 1 yr, 30% at 18 mo. and .apprx. 19% after 2.5 yr. There was no correlation of biopsy results with preirradiation estrogen or orchiectomy, time-dose-fractionation relationships or prognosis. These biopsies provide interesting data about the regression rate of prostatic adenocarcinoma, but they have no significance for the individual patient. They were eliminated from follow-up studies.