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Focal therapy for prostate cancer

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https://www.readbyqxmd.com/read/28796935/focal-irreversible-electroporation-as-primary-treatment-for-localized-prostate-cancer
#1
Willemien van den Bos, Matthijs J Scheltema, Amila R Siriwardana, Anton M F Kalsbeek, James E Thompson, Francis Ting, Maret Böhm, Anne-Maree Haynes, Ron Shnier, Warick Delprado, Phillip D Stricker
OBJECTIVES: To determine the safety, quality of life (QoL) and short-term oncological outcomes of primary focal IRE for the treatment of localized prostate cancer. To identify potential risk factors for oncological failure. PATIENTS AND METHODS: Patients that met both the consensus guidelines on patient criteria and selection methods for primary focal therapy were eligible for analysis. Focal IRE was performed for organ-confined clinically significant PCa, being high-volume Gleason sum score 6 (ISUP grade 1) or any Gleason sum score 7 (ISUP grade 2-3)...
August 10, 2017: BJU International
https://www.readbyqxmd.com/read/28777073/multimodality-image-fusion-with-psma-pet-ct-and-high-intensity-focused-ultrasound-focal-therapy-for-primary-diagnosis-and-management-of-prostate-cancer-a-planned-research-initiative
#2
Marcia C Javitt, Alexander Kravtsov, Zohar Keidar, Sobhi Abadi, Gilad Amiel
Recent developments in diagnostic imaging herald a new approach to diagnosis and management of prostate cancer. Multimodality fusion that combines anatomic with functional imaging data has surpassed either of the two alone. This opens up the possibility to "find and fix" malignancy with greater accuracy than ever before. This is particularly important for prostate cancer because it is the most common male cancer in most developed countries. This article describes technical advances under investigation at our institution and others using multimodality image fusion of magnetic resonance imaging (MRI), transrectal ultrasound (TRUS), and PSMA PET/CT (defined as the combination of prostate-specific membrane antigen [PSMA], positron emission tomography [PET], and computed tomography [CT]) for personalized medicine in the diagnosis and focal therapy of prostate cancer with high-intensity focused ultrasound (HiFUS)...
August 3, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28725587/multi-parametric-mri-imaging-of-the-prostate-implications-for-focal-therapy
#3
REVIEW
James S Wysock, Herbert Lepor
The primary goal of a focal therapy treatment paradigm is to achieve cancer control through targeted tissue destruction while simultaneously limiting deleterious effects on peri-prostatic structures. Focal therapy approaches are employed in several oncologic treatment protocols, and have been shown to provide equivalent cancer control for malignancies such as breast cancer and renal cell carcinoma. Efforts to develop a focal therapy approach for prostate cancer have been challenged by several concepts including the multifocal nature of the disease and limited capability of prostate ultrasound and systematic biopsy to reliably localize the site(s) and aggressiveness of disease...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28725581/direct-magnetic-resonance-imaging-guided-biopsy-of-the-prostate-lessons-learned-in-establishing-a-regional-referral-center
#4
REVIEW
Benjamin Addicott, Bryan R Foster, Chenara Johnson, Alice Fung, Christopher L Amling, Fergus V Coakley
MRI-targeted biopsy of the prostate appears to have the potential to reduce the high rates of underdiagnosis and overdiagnosis associated with the current diagnostic standard of transrectal ultrasound guided systematic biopsy. Direct or "in bore" MRI-guided biopsy is one of the three methods for MRI-targeted core needle sampling of suspicious, generally Pi-RADS 4 or 5, foci within the prostate, and our early experience suggests the approach demonstrates substantial utility and promise in the care of patients with prostate cancer...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28713796/multimodal-imaging-in-focal-therapy-planning-and-assessment-in-primary-prostate-cancer
#5
Hossein Jadvar
PURPOSE: There is increasing interest in focal therapy (male lumpectomy) of localized low-intermediate risk prostate cancer. Focal therapy is typically associated with low morbidity and provides the possibility of retreatment. Imaging is pivotal in stratification of men with localized prostate cancer for active surveillance, focal therapy or radical intervention. This article provides a concise review of focal therapy and the evolving role of imaging in this clinical setting. METHODS: We performed a narrative and critical literature review by searching PubMed/Medline database from January 1997 to January 2017 for articles in the English language and the use of search keywords "focal therapy", "prostate cancer", and "imaging"...
June 2017: Clinical and Translational Imaging: Reviews in Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28690772/bladder-urothelial-carcinoma-extending-to-rectal-mucosa-and-presenting-with-rectal-bleeding
#6
Andrew M Aneese, Vinayata Manuballa, Mitual Amin, Mitchell S Cappell
An 87-year-old-man with prostate-cancer-stage-T1c-Gleason-6 treated with radiotherapy in 1996, recurrent prostate cancer treated with leuprolide hormonal therapy in 2009, and bladder-urothelial-carcinoma in situ treated with Bacillus-Calmette-Guerin and adriamycin in 2010, presented in 2015 with painless, bright red blood per rectum coating stools daily for 5 mo. Rectal examination revealed bright red blood per rectum; and a hard, fixed, 2.5 cm × 2.5 cm mass at the normal prostate location. The hemoglobin was 7...
June 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28688020/salvage-therapy-options-for-local-prostate-cancer-recurrence-after-primary-radiotherapy-a-literature-review
#7
REVIEW
Nicole M Golbari, Aaron E Katz
PURPOSE OF REVIEW: While recurrence after primary treatment of prostate cancer (PCa) is not uncommon, there is currently no consensus on the most appropriate management after radiation treatment failure. This article seeks to explore the currently utilized modalities for salvage treatment for radiorecurrent PCa. We focused our review on the oncologic outcomes and reported toxicity rates in the latest studies examining salvage radical prostatectomy (SRP), salvage cryotherapy (SCT), salvage high-intensity focused ultrasound (HIFU) and re-irradiation...
August 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28674082/intratumoral-sting-activation-with-t-cell-checkpoint-modulation-generates-systemic-antitumor-immunity
#8
Casey R Ager, Matthew J Reilley, Courtney Nicholas, Todd Bartkowiak, Ashvin R Jaiswal, Michael A Curran
Coordinated manipulation of independent immune regulatory pathways in the tumor microenvironment-including blockade of T-cell checkpoint receptors and reversal of suppressive myeloid programs-can render aggressive cancers susceptible to immune rejection. Elevated toxicity associated with combination immunotherapy, however, prevents translation of the most efficacious regimens. We evaluated T-cell checkpoint-modulating antibodies targeting CTLA-4, PD-1, and 4-1BB together with myeloid agonists targeting either STING or Flt3 in the TRAMP-C2 model of prostate cancer to determine whether low-dose intratumoral delivery of these agents could elicit systemic control of multifocal disease...
August 2017: Cancer Immunology Research
https://www.readbyqxmd.com/read/28654336/focal-therapy-for-prostate-cancer-with-in-bore-mr-guided-focused-ultrasound-two-year-follow-up-of-a-phase-i-trial-complications-and-functional-outcomes
#9
Kae Jack Tay, Christopher W S Cheng, Weber K O Lau, James Khoo, Choon Hua Thng, Jin Wei Kwek
Purpose To report the safety profile and 2-year functional outcomes of in-bore magnetic resonance (MR)-guided focused ultrasound on single cancer foci in men with prostate cancer. Materials and Methods Ethics approval was obtained from the centralized institutional review board for this prospective single-arm study, and patients provided informed consent. Patients with untreated low-volume low-grade prostate cancer (clinical stage T2a or lower; Gleason score, 3+3; index tumor ≤10 mm(3)) underwent MR-guided focused ultrasound between July 2011 and February 2013...
June 26, 2017: Radiology
https://www.readbyqxmd.com/read/28635336/new-advances-in-focal-therapy-for-early-stage-prostate-cancer
#10
REVIEW
Kae Jack Tay, Ariel A Schulman, Christina Sze, Efrat Tsivian, Thomas J Polascik
Prostate focal therapy offers men the opportunity to achieve oncological control while preserving sexual and urinary function. The prerequisites for successful focal therapy are to accurately identify, localize and completely ablate the clinically significant cancer(s) within the prostate. We aim to evaluate the evidence for current and upcoming technologies that could shape the future of prostate cancer focal therapy in the next five years. Areas covered: Current literature on advances in patient selection using imaging, biopsy and biomarkers, ablation techniques and adjuvant treatments for focal therapy are summarized...
August 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28601561/the-3dbiopsy-prostate-biopsy-system-preclinical-investigation-of-a-needle-actuator-and-specimen-collection-device-allowing-sampling-of-individualized-prostate-lengths-between-20-and-60%C3%A2-mm
#11
Nelson N Stone, Vladimir Mouraviev, David Schechter, M Scott Lucia, Elizabeth E Smith, Paul Arangua, John Hoenemeyer, Jim Rosa, Rajan Bawa, E David Crawford
OBJECTIVE: To increase the likelihood of detecting anterior cancers within the prostate and provide a specimen that spans the length of the gland. Newly designed 17- and 15-gauge (G) biopsy needles, a variable actuator, and an integrated pathology system intended for the longer cores were developed and tested for this purpose. MATERIALS AND METHODS: Testing was performed comparing 2 common cannula tip grinds, a Vet-point (sharp tip) and a Menghini-point (atraumatic tip), and were tested against 18-G Bard Monopty in porcine kidney...
June 7, 2017: Urology
https://www.readbyqxmd.com/read/28579687/therapeutic-ultrasound-and-prostate-cancer
#12
REVIEW
Karthik M Sundaram, Sam S Chang, David F Penson, Sandeep Arora
Therapeutic ultrasound approaches including high-intensity focused ultrasound (HIFU) are emerging as popular minimally invasive alternative treatments for localized, low-to-intermediate risk prostate cancer. FDA approval was recently granted for two ultrasound-guided HIFU devices. Clinical trials for devices using MRI guidance are ongoing. The current level of evidence for whole-gland ultrasound ablation suggests that its clinical efficacy and adverse event rates including erectile dysfunction and urinary incontinence are similar to current definitive therapies such as radical prostatectomy and external-beam radiotherapy...
June 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28569345/vascular-targeted-photodynamic-therapy-with-tookad%C3%A2-soluble-wst11-in-localized-prostate-cancer-efficiency-of-automatic-pre-treatment-planning
#13
N Betrouni, S Boukris, F Benzaghou
Vascular targeted photodynamic therapy (VTP) with WST11 is a novel non-thermal focal treatment for localized prostate cancer that has shown favorable and early efficacy results in previously published studies. In this work, we investigate the efficiency of automatic dosimetric treatment planning. An action model established in a previous study was used in an image-guided optimization scheme to define the personalized optimal light dose for each patient. The calculated light dose is expressed as the number of optical cylindrical fibers to be used, their positions according to an external insertion grid, and the lengths of their diffuser parts...
August 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28540788/salvage-focal-cryosurgery-may-delay-use-of-androgen-deprivation-therapy-in-cryotherapy-and-radiation-recurrent-prostate-cancer-patients
#14
Michael Kongnyuy, Courtney J Berg, Kaitlin E Kosinski, David J Habibian, Jeffrey T Schiff, Anthony T Corcoran, Aaron E Katz
INTRODUCTION: Salvage treatment options for recurrent unilateral prostate cancer (PCa) after primary radiation are limited and associated with severe complications and poor quality of life measures. Salvage focal cryotherapy (SFC) has shown success in biochemical recurrence (BCR) free survival. We aim to determine if SFC can delay use of androgen deprivation therapy (ADT) in recurrent PCa with low morbidity. METHODS: A retrospective review of patients who underwent SFC at our institution from 2007 to 2015 was performed...
March 29, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28478960/use-of-reduced-field-of-view-acquisition-to-improve-prostate-cancer-visualization-on-diffusion-weighted-magnetic-resonance-imaging-in-the-presence-of-hip-implants-report-of-2-cases
#15
Andrew B Rosenkrantz, Samir S Taneja
In patients with metallic hip implants, distortions, and other artifacts relating to the echo-planar imaging acquisition may render prostate diffusion-weighted imaging (DWI) nondiagnostic. Reduced field-of-view (rFOV) acquisition, using parallel transmission and focused excitation, is a novel DWI approach that reduces distortions and improves images quality. This article presents images from both standard and rFOV DWI acquisitions in 2 prostate cancer patients with hip implants, showing the effect of rFOV DWI for improving tumor localization...
March 18, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28477079/-irreversible-electroporation-ire-a%C3%A2-minimally-invasive-therapeutic-option-in-prostate-cancer
#16
REVIEW
P Wiggermann, K Brünn, W Bäumler
CLINICAL PROBLEM: Prostate cancer is one of the most common malignant diseases in older men. As such, screening and early detection are of crucial importance. STANDARD TREATMENT: The standard management of prostate cancer includes radical prostatectomy, radiation therapy, or hormonal therapy. These standard therapies yield excellent oncologic results, but also produce significant side effects. In cases of low-risk prostate cancer, these therapies might result in over-treatment; for this reason, active surveillance has been introduced...
August 2017: Der Radiologe
https://www.readbyqxmd.com/read/28462605/editorial-comment-on-tay-et-al
#17
Joseph L Chin
No abstract text is available yet for this article.
June 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28443145/initial-single-centre-canadian-experience-with-18f-fluoromethylcholine-positron-emission-tomography-computed-tomography-18f-fch-pet-ct-for-biochemical-recurrence-in-prostate-cancer-patients-initially-treated-with-curative-intent
#18
Simon Gauvin, Yannick Cerantola, Eléonore Haberer, Vincent Pelsser, Stephan Probst, Franck Bladou, Maurice Anidjar
INTRODUCTION: We sought to determine predictive factors (patient and prostate-specific antigen [PSA] characteristics) for 18F-fluoromethylcholine positron emission tomography-computed tomography (18F-FCH PET/CT) positivity in the context of biochemical recurrence after local treatment of prostate cancer (PCa) with curative intent. METHODS: This is a retrospective study including 60 18F-FCH PET/CT scans of patients with biochemical recurrence after initial radical prostatectomy (RP), external beam radiation therapy (EBRT), or focal high-intensity focused ultrasound (HIFU) with curative intent...
January 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28439616/-high-intensity-focused-ultrasound-hifu-importance-in-the-treatment-of-prostate-cancer
#19
R Ganzer
BACKGROUND: High intensity focused ultrasound (HIFU) has been used since the beginning of the 1990s as an alternative treatment for prostate cancer. OBJECTIVE: Overview of the current status and critical review of the different indications for HIFU in the treatment of prostate cancer. MATERIAL AND METHODS: Review of the current literature on the indications, side effects, oncologic results and current guideline recommendations. RESULTS: The principle of HIFU is based on high energy sound waves, which lead to coagulation necrosis at the focal point...
August 2017: Der Radiologe
https://www.readbyqxmd.com/read/28430624/photosensitizers-in-prostate-cancer-therapy
#20
REVIEW
Taher Gheewala, Troy Skwor, Gnanasekar Munirathinam
The search for new therapeutics for the treatment of prostate cancer is ongoing with a focus on the balance between the harms and benefits of treatment. New therapies are being constantly developed to offer treatments similar to radical therapies, with limited side effects. Photodynamic therapy (PDT) is a promising strategy in delivering focal treatment in primary as well as post radiotherapy prostate cancer. PDT involves activation of a photosensitizer (PS) by appropriate wavelength of light, generating transient levels of reactive oxygen species (ROS)...
May 2, 2017: Oncotarget
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