Continuous course of megavoltage radiotherapy for carcinoma of the prostate.

Between 1978 and 1983, 55 patients with advanced carcinoma of the prostate (38 with Stage C and 17 with Stage D) were treated with external beam MeV radiotherapy. In 29 patients radiotherapy was the first treatment modality, and 26 patients had previously received hormonal therapy. Both treatment modalities were continued simultaneously for Stage D and bulky Stage C of the disease. Severe urodynamic problems were the main treatment indications for patients with Stage D carcinoma. The treatment consisted of two courses each of 25 gray (Gy) whole pelvic irradiation, interrupted for 2 weeks to deliver a rotation field to the prostate at a dose of 20 Gy. Patients have been followed for a minimum of 36 months. For patients with Stage C disease the overall 3-year survival was 80%, with 55% disease-free survival. Palliative irradiation for Stage D prostatic carcinoma improves the quality of life and probably the survival rate. Acute minor complications were observed in 49% of the patients, and chronic complications occurred in 14% of the patients. The described MeV technique is well tolerated and effective for Stage C as well as for Stage D prostatic cancer patients.