ABSTRACT
A series of 245 patients with prostate cancer treated by external irradiation was analysed to assess the impact of irradiation on urinary outlet obstruction. Prior to irradiation, obstruction was observed in 147/245 patients (60%). Irradiation either with or without hormonal therapy was as efficacious as transurethral resection of the prostate (TURP) in alleviating obstructive symptoms; 14/16 patients treated by irradiation alone responded, as did 19/19 who received hormonal therapy and irradiation and 109/112 who underwent TURP and irradiation. Following irradiation, 41/245 patients developed post-irradiation obstruction, 26/213 had post-irradiation strictures and 15/32 developed recurrent cancer. Surgical intervention was required less often for the management of recurrent obstruction caused by stricture as compared with recurrent cancer. TURP and urinary outlet obstruction acted as independent and additive variables to the development of post-irradiation stricture. Thus the avoidance of TURP in patients with obstructive symptoms reduced but did not eliminate the risk of developing a stricture.
Subject(s)
Prostatic Neoplasms/radiotherapy , Urethral Stricture/etiology , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Prostate/surgery , Prostatectomy/methods , Prostatic Neoplasms/complications , Prostatic Neoplasms/surgery , Radiotherapy/adverse effects , Recurrence , Risk Factors , Urethral Obstruction/etiologyABSTRACT
Results in 256 cases of malignant disease treated by multifraction combination hyperthermia-radiation therapy under the supervision of one physician are presented. The overall response rate was 94% including a 62% complete response. Complications specifically ascribed to hyperthermia were minor, and most side effects of combined treatment were radiation dose related. Tumor response was somewhat better for chest wall recurrence (72% CR) and for adenocarcinoma in general (64% CR), but no significant dependence on tumor site or type was found. Most patients were treated with low dose external radiation with hyperthermia given by air cooled microwave applicators or intracavitary antennae operating at 915 or 300 MHz, and some by interstitial microwave antennae plus 192 Ir. Results appeared to be independent of the microwave source employed. Response did depend on radiation dose: complete response rate with 4000 rad was 65%, and with 2000 rad was 42%.
