ABSTRACT
Background and purpose:Radiotherapy is the common method for treatment of prostate carcinoma,but some patients cannot tolerate the side effects caused by conventional pelvic radiation.MRI can display clearly the disease in the prostate and surrounding tissue.Modified pelvic radiation directed by MRI staging system can reduce the adverse reaction.This study was to evaluate the value of Magnetic Resonance Imaging(MRI) Staging(TNM staging system) in radiotherapy of prostate carcinoma.Methods:From 1998 to 2003 Sixty-three patients with prostate carcinoma who were confirmed as stage T_(1-2)N_(0)M_(0) by MRI staging system were randomly allocated into two arms: 29 patients in arm A were treated with conventional pelvic radiation(D_(T)4000-4500cGy),and 34 patients in arm B received modified pelvic radiation(D_(T)4000-4500cGy),then 2500-3000cGy were added by conformal radiation therapy.Results:After median follow-up of 61 months,the median survival time was 82 months for conventional pelvic radiation group compared with 76.3 months for modified pelvic radiation group(P=0.673);5-year overall survival rates were 83.97% and 79.64% for conventional pelvic radiation group and modified pelvic radiation group,respectively.The median PSA failure-free survival time for two arms was similar,59 month(conventional pelvic radiation group) versus 60 months(modified pelvic radiation group)(P=(0.859));5-year PSA failure-free survival rates were 42.37% for conventional pelvic radiation group and 49.01% for modified pelvic radiation group,respectively.The morbidity such as acute/chronic gastrointestinal and genitourinary side effects were higher in conventional pelvic radiation group than in modified pelvic radiation group.Conclusions:The local control rates and survival rates for patients with staging T_(1-2)N_(0)M_(0) prostate carcinoma who received modified radiotherapy or conventional radiotherapy were similar,but the toxicities of modified radiotherapy were significantly less than that of conventional radiotherapy.
