Potential for radiotherapy alone in prostatic cancer.

External beam irradiation was introduced in the 1930s for the palliation of advanced pelvic obstructive disease from carcinoma of the prostate. This treatment was superseded in the early 1940s by hormone deprivation, a remarkably effective method for palliating advanced prostatic cancer. It took some years to recognize, however, that these methods were not curative. In the mid 1950s, aggressive radiation treatment was reintroduced, largely because of the availability of deeply penetrating gamma and x-rays produced by cobalt units, linear accelerators, and betatrons. One extensive series was started at Stanford in 1956; currently over 800 patients are available for analysis. Four hundred fifty-eight patients had disease limited to the prostate (nominal Stages T2 or B), and their survival is 80% +/- 2.0% (+/- 1 standard error) at 5 years, 58% +/- 2.8% at 10 years, and 36.7% +/- 3.8% at 15 years. Three hundred eighty-five patients had extracapsular extension (nominal Stages T3 or C) and their survival is 60% +/- 5.4% at 5 years, 36% +/- 2.9% at 10 years, and 22% +/- 3.5% at 15 years. This study has demonstrated that long-term disease-free survival can be achieved after appropriate prostatic irradiation.