Treatment of prostatic carcinoma in clinical stage C. Comparison between radiotherapy plus hormonal therapy after progression and immediate hormonal therapy

: The optimal treatment of prostate cancer in clinical stage C is controversial. On the one hand a disease still confined by definition, as stage C is, should require a curative therapy such as surgery or radiotheratherapy. On the other hand the known fact that 50% of stages C are pathological stages D1, should propose a palliative, even thou effective, medical treatment. In fact both choices are questionable. A radical treatment risks being insufficient, whereas a palliative does not allow for giving a chance of a theoretically possible cure. In an attempt to resolve this difficulty, a sort of compromise is proposed. The patients should be initially treated with radical radiotherapy, and only in the case of progression will standard hormonotherapy be given. Thanks to this behaviour a possibility of cure is maintained, and, in addition, when suffering a progression the patients are likely to benefit from hormonotherapy owing to the fact that they are not pretreated. From 1985 to 1991 forty-eight clinical stage C patients were observed. They were given the choice between two treatments after explaining the theoretical benefits and disadvantages of both. Treatment A consisted of cobalt-60 therapy followed by hormonotherapy after progression, treatment B in primary ormonotherapy with LH-RH analogue +/- Flutamide. Twenty patients opted for treatment A and 21 for B.(ABSTRACT TRUNCATED AT 250 WORDS)