1003 THE ROLE OF PROSTATIC ACID PHOSPHATASE IN THE RADIOTHERAPEUTICMANAGEMENT OF ADENOCARCINOMA OF THE PROSTATE Jeffrey C. Carlton, M.D., Gunar K. Zagars, M.D., Mary Jane Oswald, B.S. The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, Texas
Between 1965 and 1984, 472 patients treated with external beam radiation therapy (EBRT) for adenocarcinoma of the prostate had pretreatment and follow-up serum prostatic acid phosphatase (PAP) measurements performed by the Roy method. All patients were clinically staged (46 A2, 67 B, and 359 C), and none had hormonal manipulation prior to relapse. Four hundred and twenty-five had pretreatment PAP values in the normal range (0.00 - 0.80 mIU/ml) and had an actuarial 5-year disease-free survival (DFS) of 67% (A 89%, B 93%, and C 59%). Forty-seven patients had elevated pretreatment PAP values. Three of these patients ha?lA3 or B disease, and all have remained disease free. The remaining 44 patients were in Stage C and had a 5-year D S of 38%. This was significantly worse than the 59% DFS observed in the normal-PAP Stage C group (p 0.4 but <0.8 (P
offer improvements in lcx:oAr;r:elerat]on and hyperfractlonatlon of radIotherapy sizhcdules c:an throretlcally Wr have investigated regional tunour <:ontrol wlthout increaslng the risk of severe damage to normal tlssups. satisfactory vo(;al quality c:an be wtainod sur:h a s<:hedul? in advan<:ed laryng?al <:ancrr t@ assess whether without ~:or~promlslng tumour (:ontro? ard survival. with Stagrs III & IV squamous <:ar-<:lrom;i of the 1aryr.x (12 glottlc:, Slni;e June 1985, 28 patients glottlc) have been treated with three frxtions of 1.1Gy per day, givrn at 3-4h Intervals, flvc days a total of approximately 60Gy 1s given over a four we?k period without lntrrruptlon.
16 supraper week;
twenty patlcnts a~‘? R!~VC at th? time of writing, all The two-year a<:tunrial survival rat? IS 57%: All but two of these survivors r:llnically free of dlsrasr and without severe i:omp11<:ations of treatment. as assessed by a Spre<:h TherapIst. retained good vo~:al quality, radiotherapy Our lnitlal pxperlrn<:e with this a(:(:?lrrated, hyperfra,:tlonated of fun,:ticn in this of both lo<:o-rrglonal dispasc <.ontrol and preservation advan(:ed laryngeal <,an<:t=r. terms
si:hrdulr 1s ?ncouraglng group of patlrnts with