Subject(s)
Carcinoma, Squamous Cell/therapy , Urethral Neoplasms/therapy , Combined Modality Therapy , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: To study the effectiveness of radiation therapy (RT) for the primary tumour and for groin node and distant metastases in patients with squamous cell carcinoma of the penis. SUBJECTS AND METHODS: Between January 1959 and June 1988, 156 patients with negative lymph nodes in the groin underwent RT of the primary tumour. RT was also administered to 120 patients with lymph node involvement in the groin and to nine with distant metastases. RESULTS: Local control of the primary tumour was achieved in 65% of patients with RT alone and in another 33% with salvage surgery. Lymph node recurrence in the groin was seen in 11% of patients and the corrected 5-year disease-free survival was 87%. Pre-operative inguinal RT was useful in patients with mobile lymph nodes > or = 4 cm in size in the groin, with only 8% of such lymphadenectomy specimens showing perinodal infiltration and only 3% of such patients having post-operative groin recurrences. Pelvic and/or para-aortic RT was ineffective in patients with pelvic node metastases. Palliative RT resulted in amelioration of symptoms in 56% of patients with fixed lymph nodes in the groin, all five patients with painful bony metastases and one of two patients with cord compression and paraplegia. CONCLUSION: Radiation therapy is ideal for patients with T1 and T2 primary cancers of the penis. Pre-operative RT is useful for patients with mobile lymph nodes > or = 4 cm in size in the groin. RT provides effective palliation in patients with advanced regional disease and/or distant metastases.
Subject(s)
Carcinoma, Squamous Cell/radiotherapy , Penile Neoplasms/radiotherapy , Brachytherapy , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/surgery , Disease-Free Survival , Follow-Up Studies , Groin , Humans , Lymphatic Metastasis , Male , Neoplasm Recurrence, Local , Palliative Care , Penile Neoplasms/mortality , Penile Neoplasms/surgery , Prognosis , Retrospective Studies , Salvage Therapy , Survival Analysis , Treatment OutcomeABSTRACT
One thousand thirty-seven female breast cancers were treated at the Cancer Institute (WIA), Madras, between 1965 and 1978. Five hundred twenty-one of them (ie, just over 50%) were in stage III, with extensive local disease, unsuitable for surgery ab initio. Four hundred twelve of them (group A) received radiation therapy (RT) initially and 109 (group B) a combination of radiation and chemotherapy (CT). In 68% of the former and 77% of the latter the tumours became resectable after this preliminary treatment. Radical mastectomy in group A and Patey's mastectomy in group B were performed. The material in these two groups was similar. The five-year survival NED in group A was 45%, and in group B 64.61%. Adequate surgery following RT and CT seemed essential to improve survival. The impact of added chemotherapy (CT) was mainly felt in the node-positive cases.
