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Radical external radiation therapy of localized prostatic carcinoma


Tenth International Congress of Radiology Book of Abstracts, Montreal, Quebec, Canada No 923(b) p 273
Radical external radiation therapy of localized prostatic carcinoma
Kerr and Flocks have demonstrated that primary carcinoma of the prostate responds to irradiation derived from the interstitial application of radioactive colloidal gold. Furthermore, it has been estimated that in about 40 percent of the patients with carcinoma of the prostate the neoplasm is limited to the prostate, capsule or pericapsular region. Thus, while most of such patients are not candidates for radical prostatectomy, their relatively localized disease is ideally suited for local irradiation. It seemed to us that the prostatic region might be more homogenously irradiated by a well-collimated supervoltage external source, such as the Stanford Medical Linear Accelerator, than by an interstitial radioisotope. Since 1956, approximately 60 patients with localized but non-resectable carcinoma of the prostate have been treated. The technique depends upon accurate localization of the tumor and beam direction in order to develop a rotational isodose pattern. Two to six year follow-up on about the first 45 patients treated in this manner demonstrated that local control of the disease was possible in approximately 80 percent of the cases, while in about 50 percent no further evidence of neoplasm, either local or metastatic, was detected. These results compare favorably with those obtained by radical perineal prostatectomy, even though prostatectomy is usually applied to earlier lesions. In most patients the treatment was tolerated exceedingly well. The selection of patients, technique, follow-up and analysis of complications will be presented in detail. With the availability of well-collimated supervoltage devices expanding rapidly, it is hoped that this method of treatment may become available to an increasing number of patients.


Accession: 025336189



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