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THERMORADIOTHERAPY FOR PROSTATE
CANCERJames I. Bicher, M.D., Ralph S. Wolfstein, M.D., Boris
Burmistrovich, M.D., Tressia Keen, M.N.
Valley Cancer Institute, Los Angeles, California, U.S.A
.Alternative cancer treatment, alternative breast cancer
treatment, alternative prostate cancer treatment.
SUMMARY
Alternative cancer
treatment, alternative breast cancer treatment, alternative prostate cancer treatment.
From the period since 1992 until 2008,
47 patients
with primary prostate cancer were treated at the Valley Cancer Institute. This group was
treated with local hyperthermia and low radiation
dose therapy (IMRT in the last year).
Thirty of them had disease in a comparably early
stage, with local and/or regional involvement but no disseminated metastatic disease. In
this group of patients we experienced a complete response (CR) rate of 100%. There was one
local recurrence and no metastatic dissemination. All these patients experienced a
decrease in PSA results, disappearance or significant improvement of local symptoms and
preservation or improvement of sexual function .Alternative
cancer treatment, alternative breast cancer treatment, alternative prostate cancer
treatment.
Another group of seven patients presented with
disease in advanced stage. In this group we experienced local response rate: 80% complete
response (CR), and 20% partial response (PR). However all these patients presented with or
developed later distant metastatic disease. A decrease in the PSA was observed in 40% of
these patients, and local symptoms improved significantly or disappeared in all cases.
However, this entire group has expired .Alternative
cancer treatment, alternative breast cancer treatment, alternative prostate cancer
treatment.
During the course of therapy patients experienced no
major side-effects, except minor symptoms of bowel irritation and some degree of skin
reaction in the perineal region .Alternative cancer
treatment, alternative breast cancer treatment, alternative prostate cancer treatment.
This study confirms the value of hyperthermia in
conjunction with radiation therapy to control locally advanced prostate cancer, especially
in its early stages .Alternative cancer treatment,
alternative breast cancer treatment, alternative prostate cancer treatment.
Thermoradiotherapy proves to be useful in later
stages to improve local symptomatology, especially pain and urinary retention, without
significant side-effects .Alternative cancer
treatment, alternative breast cancer treatment, alternative prostate cancer treatment.
Introduction Alternative
cancer treatment, alternative breast cancer treatment, alternative prostate cancer
treatment.
Results of radiotherapy for prostatic carcinoma have been excellent
with mostly acceptable side effects (1,2,3). Can they be improved with the addition of
hyperthermia? Published comparison studies on tumors at other sites show a thermal
enhancement ratio (TER) of 1.88 with no increase in toxicity, except for occasional
thermal burns. It has been our general impression that toxicity may actually be less with
the addition of hyperthermia than might be anticipated from the same dose of radiation
alone.
Herein our preliminary results using thermoradiotherapy for prostate
cancer are presented.
Method and Materials Alternative
cancer treatment, alternative breast cancer treatment, alternative prostate cancer
treatment.
Twenty seven patients with prostatic cancer were treated with
thermoradiotherapy between 1/92 and 10/00. These men ranged in age from 56 to 78. Eight
patients had disease probably confined to the prostate gland. Five had invasion beyond the
gland and/or metastatic disease. Radiotherapy was delivered through opposing anterior and
posterior portals, 90 cGy to each daily using a MV linear accelerator. The pelvis received
45 Gy and the prostate was boosted to 65 Gy in 8 weeks on average.
Hyperthermia was delivered within one hour before or after each
radiotherapy fraction using ultrasound or 300 MHz Microwave equipment alternately.
Ultrasound was directed to the gland and mid pelvis, microwave to the prostate.
Results Alternative cancer
treatment, alternative breast cancer treatment, alternative prostate cancer treatment.
Twenty of the twenty seven patients treated had disease in a
comparably early stage, with local and /or regional involvement but no disseminated
metastatic disease. In this group of patients we experienced a complete response (CR) rate
of 100%. There was no local recurrence or metastatic dissemination. All these patients
experienced a decrease in PSA results, disappearance or significant improvement of local
symptoms and preservation or improvement of sexual function (see table).
Another group of five patients presented with more advanced disease.
In this group we experienced a local response rate as follows: 80% complete response (CR),
and 20% partial response (PR). However all these patient presented with or developed later
distant metastatic disease. A decrease in the PSA was observed in 40% of these patients,
and local symptoms improved significantly or disappeared in all cases. All 5 of these
patients eventually expired.
During the course of therapy patients experienced no major
side-effects, except minor symptoms of bowel irritation and some degree of skin reaction
in the perineal region .Alternative cancer treatment,
alternative breast cancer treatment, alternative prostate cancer treatment.
Alternative cancer treatment, alternative breast
cancer treatment, alternative prostate cancer treatment.
LOCAL PROSTATE CANCER PATIENTS
TREATED WITH RADIATION ! 65 Gy ! + HYPERTHERMIA
( PERIOD FROM 1992 TO 2000 )
TOTAL # OF
TREATED PATIENTS: 47 |
EARLY
DISEASE: 20
# (%) |
ADVANCED
DISEASE: 7
# (%) |
| COMPLETE RESPONSE |
20 (100) |
4 (80) |
| PARTIAL RESPONSE |
0 (0) |
3 (20) |
| LOCAL RECURRENCE |
1 (5) |
0 (0) |
| DISTANT METASTASIS |
1 (5) |
7 (100) |
| SEXUAL FUNCTION
|
Increase |
13 (66) |
NO FOLLOW
UP |
Decrease |
0 (0) |
- |
No change |
7 (33) |
- |
| PSA AFTER
TREATMENT (FOLLOW UP UNTIL 2000 OR UNTIL PATIENT EXPIRED)
|
Increase |
0 (0) |
4 (60) |
Decrease |
20 (100) |
0 (0) |
| No change |
0
0) |
3 (40) |
| PATIENTS ALIVE AT PRESENT TIME
(LENGTH OF FOLLOW UP: 1 TO 3 YEARS) |
20 (100) |
0 (0) |
| SYMPTOMS IMPROVED AFTER
TREATMENT |
COMPLETE |
18 (91) |
7 (100) |
| PARTIAL |
2 (9) |
0 (0) |
Discussion
Alternative
cancer treatment, alternative breast cancer treatment, alternative prostate cancer
treatment.
This study confirms the value of hyperthermia in conjunction with
radiation therapy to control locally advanced prostate cancer, especially in its early
stages. Thermoradiotherapy proves to be useful in later stages to improve local
symptomatology, especially pain and urinary retention, without significant side-effects.
Tumor grade has also not shown any correlation. It was of interest that the one patient
who had distant metastasis was the only patient who failed to have complete local tumor
regression.
Survival has been short in all five patients with advanced disease,
but 2 deaths were unrelated to cancer. Survival of the others cannot, of course, be
predicted; however, the improvement in their sex lives is striking. Radiotherapy has never
been reported to improve sexual function. A recent report on 53 men given radiotherapy for
prostate cancer found 77% had decreased sexual desire as well as function.
References Alternative
cancer treatment, alternative breast cancer treatment, alternative prostate cancer
treatment.
1. Beiler, D.E.; Wright, D.J.; Reddy, G.N.
"Radical external radiotherapy for prostatic carcinoma". International
Journal of Radiation Biological Physics. 7: 885-890; 1981.Alternative cancer treatment, alternative breast cancer treatment, alternative
prostate cancer treatment.
2. Hahn, P.; Baral, E.; Cheang,M.; Math, M.; Kostyra,
J.; Roelss, R. "Long -term outcome of radical radiation therapy for prostatic
carcinoma: 1967 - 1987" . International Journal of Radiation Biological Physics.
34: 41-47; 1996.
3. Harisiadis, D.; Veeneng, R.J.; Senyzyn, J.J.;
Puchner, P.J.; Tretter, P; Romas, N.A.; j Chang, C.H.j.; Lattiment, J.K.; Tannenbaum, M.
"Carcinoma of the prostate: Treatment with external radiotherapy". Cancer 41:
2131-2142; 1978.
4. Bicher, H.I.; Wolfstein, R.S. "Clinical use of
regional hyperthermia". In: Bicher, H.I. Consensus on Hyperthermia for the 1990's :
1-20; New York: Plenum Press; 1990.Alternative
cancer treatment, alternative breast cancer treatment, alternative prostate cancer
treatment.
5. Helgason, A.R.; Fredrikson, M.; Adolfsson, J.;
Steineck, G.. "Decreased sexual capacity after external radiation therapy for
prostate cancer impairs quality of life". International Journal of Radiation
Biological Physics 32: 33-39; 1995.
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