Prognostic significance of prostate specific antigen PSA in patients with non-metastasic carcinoma of the prostate

Prostatic carcinomas vary in their biologic potential. Serum prostate specific antigen, stage, tumor grade and Gleason's grade were studied in patients with non-metastatic carcinoma of prostate. Thirty-six patients with non-metastatic carcinoma of prostate were included in this study of stage A2, B or C. Their age range was 57 to 68 years median age of 62 years. All patients were treated by external beam radiation therapy. Serum prostate specific antigen was estimated before treatment and every two-four months post treatment. Thirty-one patients were evaluable for treatment results as five patients did not attend follow up after treatment. Twenty-nine patients had their prostate specific antigen lowered to a normal level after the radiation therapy treatment [<4 ng/ml]. Two patients had lowering of their serum PSA level but to values above 4 ng/ml. The disease free survival at two-years for the whole group was 64%. Pretreatment serum PSA, Gleason's grade and stage were statistically significant predictors of disease free survival

Radiation therapy and chemotherapy in the treatment of rectosigmoid carcinomas

Carcinomas of the rectum and sigmoid colon are the most common tumours of the gastrointestinal tract. The treatment results and prognostic factors of 63 patients with stage B-C carcinomas of the rectum and simoid colon were analyzed. Thirty-one patients [49%] had stage B disease. Thirty-two patients [51%] had stage C disease. All patients had surgical resection in the form of abdomino-perineal resction, anterior resection of rectal carcinoma, or simoid colon resection. This was followed by adjuvant treatment by external beam radiation therapy [dose of 4500-5040 cGy, at 180 cGy per fraction, five fraction a week] Using Six linear accelerator, adjuvant chemotherapy was given using fluorouracil and Leucovorin, for six months. The 3-year disease free survival for the whole group was 65%. Disease free survival rate at 3 years for stage B was 74% and for stage C, was 56%. The 56% local regional recurrence rate and distant metastasis rate at 3 years for the whole group was 35%. Distant metastases rate was 30%. No life threatening complications were recorded to this multidisciplinary treatment. The stage of the disease was the most important prognostic factor in predicting the survival

Changes of urinary bladder salvage preservation in muscle invading transitional cell carcinoma of urinary bladder by the use of neoadjuvant chemotherapy and radiation therapy

Based on the excellent results obtained with chemotherapy in patients with advanced transitional cell carcinoma of urinary bladder, neoadjuvant chemotherapy has been advancated t improve survival and in some cases to permit bladder conservation. Twenty nine patients with transitional cell carcinoma of urinary bladder were seen at EBGH, Jaddah Cancer, Jan 1991-1994. All patients had tumour of either T[2] or T[3] stage N[X]-N[2] MO. Patients were given 3 cycles of CMV chemotherapy with cisplatinum, methotroxate and vinblastine. Patients who attained complete are partial response were given radioation therapy. The clinical complete response rate after chemo-radiation therapy was 59% [17/29 patients]. The 2-year disease free survival rate for the complete respondent is 76% whereas for the complete responders goups a 25% 2-year survival is attained. Surgery by radical cystectomy was offered to non responders as well as to chemoradiation therapy failures. The 2-year disease free survival with preserved bladder is 41%. Complete responders after chemoradiation therapy stand a good change of disease control with bladder preservation. Radical cystectomy is the appropriate treatment if no complete response is attained after chemotherapy