[en] The quality of life in 72 patients who had shown a complete response to radiotherapy, using a modified bladder symptom score and the Nottingham health profile, was compared with the quality of life in a similar control group matched for age and sex. There was no significant difference in either group. The records of 69 patients who had undergone post-radiation salvage cystectomy were reviewed, looking specifically at surgical complications. There were 3 post-operative deaths (5%), 3 pulmonary emboli and 3 fistulae - with some overlap of complications. Five patients who underwent cystectomy for intractable symptoms in the apparent absence of recurrent tumour were found to have residual cancer in the excised specimens. (Author)

[en] Short communication

[en] The objective was to determine the risk of post-operative complications in patients receiving high-dose pelvic irradiation before radical cystectomy and urinary diversion. The post-operative course, including the duration of hospital stay, peri-operative complications and early functional results, did not differ from a control group of non-irradiated patients, and no patients died. The mean follow-up was 22 months (range 10-37) and revealed satisfactory results in seven of 11 patients. A neovesicoperitoneal fistula developed in one woman 10 months after surgery and was repaired by laparotomy. A neovesicovaginal fistula led to supravesical urinary diversion in the second woman. High-dose pelvic irradiation should not be a primary contra-indication for orthotopic urinary diversion using segments of small intestine. For patients who undergo combined external and after loading radiotherapy, the indication for orthotopic bladder replacement should be considered critically. (Author)

[en] The objective was to assess the results of radiotherapy in the treatment of localized prostate cancer. End points for assessment were survival, local control, development of metastases, and the toxicity of therapy. Radical radiotherapy has a role in the curative treatment of prostate cancer. Survival is significantly related to T stage at the time of presentation, and to the Gleason Score of the tumour. Survival in this series was not as good as the best surgical series, but it is still not clear which patients should receive radiotherapy and which surgery as their primary management. (author)

[en] The objective was to assess sexual function before and after definitive irradiation for the treatment of cancer of the prostate. The study comprised 67 patients (mean age 68 years) treated in five radiotherapy departments and assessed with repeated questionnaires about their libido, arousal, frequency and quality of intercourse, and sexual satisfaction. Interviews were obtained before radiotherapy and at the end of the first year after treatment. Sixty-three patients were married and 50 had a sexually effective partner. Forty-six patients presented with another pathology or medical treatment capable of inducing sexual dysfunction. Before radiotherapy, 40 patients were sexually active, with good to acceptable intercourse. Between 10 and 24 months after the end of radiotherapy, no disease progression was observed and prostate-specific antigen levels remained high in only two patients. Sexual function was preserved in 67% of patients but only 50% observed no change. The functional prognosis seemed to be related to the initial frequency and quality of intercourse; more than three times per month, the prognosis remained good, under three per month, it was poor. The patient's age was a predictive factor for the frequency of intercourse. (author)

[en] The objective was to assess the quality of life (QoL) of patients with localized prostate cancer (LPC) after treatment by radical radiotherapy (RR). An ''ad hoc'' self-administered questionnaire was developed, which comprised a series of 41 items grouped into seven subscales reflecting the main QoL domains, and the questionnaire's psychometric properties were assessed. Ninety patients (76%) completed the questionnaire; because 20 of them were also treated with hormonal therapy, QoL was assessed only in the remaining 70 patients, to avoid confusion. The assessment of the psychometric properties showed that the questionnaire was valid and reliable (Cronbach's α coefficient >0.8 for each subscale). The main side effects of RR were urinary symptoms and sexual impairment, while physical, psychological and relational well-being were good. The degree of information available about the therapy and the disease seemed to play a major role in the patients' QoL adjustment after RR. (Author)

[en] We report the effect on prostatic volume of the administration of the luteinising hormone-releasing hormone (LHRH) analogue goserelin in 22 patients with locally advanced carcinoma of the prostrate; 20 achieved a significant reduction in volume, the median volume being 66 ml before treatment and 30 ml after 17 weeks. If used before external beam radiotherapy (RT), volume reduction will permit smaller boost fields and thus potentially reduce adverse radiotherapy effects. In addition, reducing tumour volume before RT may lead to an increase in local control. We discuss the possible role of hormonal volume reduction in the management of prostatic cancer. (Author)

[en] The biopsies from 75 patients with transitional cell carcinoma of the bladder (25 Ta-T1; 45 T2-T4, 5M) were studied immunohistochemically for the expression of beta-human chorionic gonadotrophin (β-HCG). Only 5 Ta-T1 tumours contained a small number of β-HCG positive cells but 24 invasive tumours and all patients with metastases showed increased numbers of positive cells. A significant correlation was found between β-HCG immunoreactivity and tumour category. In 30 patients with muscle-invasive disease (T2-T4,NO,MO) who were treated with radical radiotherapy a significant correlation was observed between response to treatment and β-HCG expression; β-HCG positive tumours did not respond to treatment. A difference in survival was found between patients with tumours negative for β-HCG compared with patients with positive tumours, all treated with radical radiotherapy. The results indicate that β-HCG expression increases with tumour invasiveness and the use of immunohistochemistry may prove a useful means of identifying radioresistant and aggressive forms of bladder cancer. (Author)

[en] We have studied 46 patients who underwent salvage cystectomy for persistent or recurrent carcinoma after radical irradiation for bladder carcinoma. The overall 5-year survival rate was 43%. There was a higher 5-year survival rate in patients with an incomplete response compared with those with a complete response to their prior irradiation (50 and 36%), in patients with grades 1 or 2 compared with grade 3 histology (75 and 28%), and in patients with T1 or T2 tumours (59 and 32%). (author)

[en] A series of 245 patients with prostate cancer treated by external irradiation was analysed to assess the impact of irradiation on urinary outlet obstruction. Prior to irradiation obstruction was observed in 147/245 patients (60%). Irradiation either with or without hormonal therapy was as efficacious as transurethral resection of the prostate (TURP) in alleviating obstructive symptoms; 14/16 patients treated by irradiation alone responded, as did 19/19 who received hormonal therapy and irradiation and 109/112 who underwent TURP and irradiation. Following irradiation, 41/245 patients developed post-irradiation obstruction, 26/213 had post-irradiation strictures and 15/32 developed recurrent cancer. Surgical intervention was required less often for the management of recurrent obstruction caused by stricture as compared with recurrent cancer. TURP and urinary outlet obstruction acted as independent and additive variables to the development of post-irradiation stricture. Thus the avoidance of TURP in patients with obstructive symptoms reduced but did not eliminate the risk of developing a stricture. (Author)