Radiotherapy for Prostatic Carcinoma: Post-Irradiation Prostatic Biopsy and Recurrence Patterns With Long-term Followup

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Abstract
From 1968-1975, 159 patients with stages A, B and C adenocarcinoma of the prostate were treated with supervoltage radiation therapy. A median dose of 7200 rad was given. The influence upon survival of grade, stage and a positive biopsy result after irradiation is analyzed. Overall survival is a patently imprecise test of local treatment because patients die of intercurrent disease and are alive with metastases for significant intervals. The classification of survival with no evidence of recurrent disease excluded those patients dying of intercurrent disease. Therefore, the rate of survival free of disease always will be greater than the overall survival rate in these patients, and a certain percentage of the patients without evidence of cancer will harbor subclinical disease. The 5 and 10 yr survival rates free of disease were 80% and 69%, respectively, in 108 patients with stage C disease. The 5 and 10 yr overall survival rates were 72 and 56%, respectively, in the former and 68 and 39%, respectively, in the latter patients. Survival free of disease and death of prostatic carcinoma were influenced adversely by advancing grade and stage (P < 0.05); overall survival was influenced adversely by grade (P = 0.02) but not stage (P < 0.05). A positive biopsy result after irradiation did not predict survival free of disease, overall survival or death of prostatic cancer in patients followed for 10 yr (P > 0.05).