Role of radiation therapy in the treatment of carcinoma of the penis.

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.