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Prostate Cancer and HIFU

Romuald Zdrojowy, Janusz Dembowski, Bartosz Małkiewicz, Krzysztof Tupikowski, Wojciech Krajewski
INTRODUCTION: Prostate cancer is the most frequent cancer among males in Europe and a leading cause of cancer deaths, with similar proportion in other developed countries. For more than twenty years, external-beam radiation therapy, alongside with radical prostatectomy, has been used as a primary radical therapeutic approach for localized prostate cancer. Yet, EBRT failures relate to 22-69% following curative radiotherapy (± androgen deprivation therapy). Additionally, a proportion of these men will have a biopsy-proven local recurrence...
2016: Central European Journal of Urology
Pascal Rischmann, Albert Gelet, Benjamin Riche, Arnauld Villers, Gilles Pasticier, Pierre Bondil, Jean-Luc Jung, Hubert Bugel, Jacques Petit, Harry Toledano, Stéphane Mallick, Olivier Rouvière, Muriel Rabilloud, Hélène Tonoli-Catez, Sebastien Crouzet
BACKGROUND: Up to a third of patients with localized prostate cancer have unilateral disease that may be suitable for partial treatment with hemiablation. OBJECTIVE: To evaluate the ability of high intensity focused ultrasound (HIFU) to achieve local control of the tumor in patients with unilateral localized prostate cancer. DESIGN, SETTING, AND PARTICIPANTS: The French Urological Association initiated a prospective IDEAL multi-institutional study (2009-2015), to evaluate HIFU-hemiablation as a primary treatment...
October 6, 2016: European Urology
Giuseppe Palermo, Angelo Totaro, Emilio Sacco, Nazario Foschi, Gaetano Gulino, Marco Racioppi, Pierfrancesco Bassi, Francesco Pinto
BACKGROUND: Prostate cancer (PCa) is the most commonly diagnosed malignancy in men and the second leading cause of cancer death in developed countries. Despite the primary treatments, 20-30% of patients experience a recurrence. The main objective of this study was to evaluate the clinical efficacy of salvage HIFU after radical prostatectomy in terms of biochemical free survival rate (BFSR) and PSA nadir. METHODS: Twenty two patients with local recurrence of Pca after radical prostatectomy underwent HIFU as first-line salvage therapy...
September 28, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Danny Badawy, Elie El Rassy, Fouad Aoun, Roland Van Velthoven
High intensity focused ultrasound (HIFU) is a minimally invasive treatment option that might be considered in the management of localized prostate cancer. It is a well-tolerated treatment with few minor urologic complications and no major toxicities. In this paper, we report to our knowledge the first case of levator ani necrosis in a patient treated with HIFU, manifesting as sturdy perineal pain, which took years of NSAID intake and serial MRIs to demonstrate partial improvement. Therefore, we regard HIFU as a serious potential treatment option that still requires longer follow-up data before its approval in the personalized treatment panel of prostate cancer...
2016: Case Reports in Urology
Louise Dickinson, Hashim U Ahmed, Richard G Hindley, Neil McCartan, Alex Freeman, Clare Allen, Mark Emberton, Alex P Kirkham
INTRODUCTION: Focal therapy for localized prostate cancer has the potential for oncological control without the side effects of radical therapies. However, there is currently no validated method for monitoring treatment success. We assessed the diagnostic performance of prostate-specific antigen (PSA) parameters and MRI compared to histological outcomes following focal therapy. PATIENTS AND METHODS: Patients from 3 Ethics Review Board approved prospective studies of focal high intensity-focused ultrasound (HIFU) (Sonablate 500) for localized prostate cancer (T1c-T3a, Gleason grade≤4+3, and PSA≤20)...
September 20, 2016: Urologic Oncology
Nicolas Mottet, Joaquim Bellmunt, Michel Bolla, Erik Briers, Marcus G Cumberbatch, Maria De Santis, Nicola Fossati, Tobias Gross, Ann M Henry, Steven Joniau, Thomas B Lam, Malcolm D Mason, Vsevolod B Matveev, Paul C Moldovan, Roderick C N van den Bergh, Thomas Van den Broeck, Henk G van der Poel, Theo H van der Kwast, Olivier Rouvière, Ivo G Schoots, Thomas Wiegel, Philip Cornford
OBJECTIVE: To present a summary of the 2016 version of the European Association of Urology (EAU) - European Society for Radiotherapy & Oncology (ESTRO) - International Society of Geriatric Oncology (SIOG) Guidelines on screening, diagnosis, and local treatment with curative intent of clinically localised prostate cancer (PCa). EVIDENCE ACQUISITION: The working panel performed a literature review of the new data (2013-2015). The guidelines were updated and the levels of evidence and/or grades of recommendation were added based on a systematic review of the evidence...
August 25, 2016: European Urology
L Hoquetis, B Malavaud, X Game, J B Beauval, D Portalez, M Soulie, P Rischmann
OBJECTIVE: To evaluate the value of MRI for surveillance of primary hemi-HIFU therapy for localized PCa in a single-center. PATIENTS AND METHODS: Patients with localized prostate cancer were treated with hemi-HIFU from October 2009 to March 2014. All patients performed MRI before focal therapy, the reader was blinded to the treatment. Oncological failure was defined as positive biopsy or biochemical recurrence (Phoenix). RESULTS: Twenty-five patients were treated with hemi-HIFU in one center...
September 2016: Progrès en Urologie
J I Perez-Reggeti, R Sanchez-Salas, A Sivaraman, E Linares Espinos, A E de Gracia-Nieto, E Barret, M Galiano, F Rozet, A Fregeville, R Renard-Penna, N Cathala, A Mombet, D Prapotnich, X Cathelineau
OBJECTIVE: We report our initial experience in the treatment of prostate cancer (PCa) with high-intensity focused ultrasound (HIFU) using the Focal-One(®) device. MATERIAL AND METHODS: Retrospective review of the prospectively populated database. Between June 2014 to October 2015, 85 patients underwent HIFU (focal/whole-gland) treatment for localized PCa. Preoperative cancer localization was done with multiparametric magnetic resonance imaging (mpMRI) and transperineal mapping biopsies...
August 16, 2016: Actas Urologicas Españolas
Rémy Rosset, Flavie Bratan, Sébastien Crouzet, Hélène Tonoli-Catez, Florence Mège-Lechevallier, Albert Gelet, Olivier Rouvière
OBJECTIVES: Our aim was to assess whether magnetic resonance imaging (MRI) features predict recurrence-free survival (RFS) after prostate cancer high-intensity focused ultrasound (HIFU) ablation. METHODS: We retrospectively selected 81 patients who underwent (i) whole-gland HIFU ablation between 2007 and 2011 as first-line therapy or salvage treatment after radiotherapy or brachytherapy, and (ii) pre- and postoperative MRI. On preoperative imaging, two senior (R1, R2) and one junior (R3) readers assessed the number of sectors invaded by the lesion with the highest Likert score (dominant lesion) using a 27-sector diagram...
July 19, 2016: European Radiology
T T Shah, M Peters, A Kanthabalan, N McCartan, Y Fatola, J van der Voort van Zyp, M van Vulpen, A Freeman, C M Moore, M Arya, M Emberton, H U Ahmed
BACKGROUND: Treatment options for radio-recurrent prostate cancer are either androgen-deprivation therapy or salvage prostatectomy. Whole-gland high-intensity focussed ultrasound (HIFU) might have a role in this setting. METHODS: An independent HIFU registry collated consecutive cases of HIFU. Between 2005 and 2012, we identified 50 men who underwent whole-gland HIFU following histological confirmation of localised disease following prior external beam radiotherapy (2005-2012)...
September 2016: Prostate Cancer and Prostatic Diseases
Khurram M Siddiqui, Michele Billia, Andrew Arifin, Fan Li, Philippe Violette, Joseph L Chin
INTRODUCTION: and Objective: The objective of this Prospective Registry was to prospectively assess the oncologic, functional and safety outcomes of salvage HIFU in radio-recurrent prostate cancer (rrPCa). METHODS: Eighty one men were prospectively recruited and evaluated at regular scheduled study visits to 6 months post-HIFU and thereafter as per standard of care. Transrectal ultrasound guided biopsy (TRUS Bx) was performed at 6 months. Primary endpoint was absence or histologic persistence of disease at 6 months Bx...
July 12, 2016: Journal of Urology
A Sivaraman
High Intensity Focused Ultrasound (HIFU) is a heat based energy source used for tissue ablation. HIFU has several clinical applications and prostate cancer ablation is one of the uses that have been explored for more than a decade. Focal therapy is an alternative treatment option for selected patients with low/intermediate PCa, that is based on complete ablation of tumor within the prostate with preservation of normal parenchyma and better preservation of Genitourinary functions. In spite of PCa being predominantly a multi-centric disease, it is postulated that a specific dominant (large volume) 'index lesion' dictates the biological behavior of the cancer and subsequent lethality of the disease...
July 2016: Archivos Españoles de Urología
Jaspreet S Arora, Hakm Y Murad, Stephen Ashe, Gray Halliburton, Heng Yu, Jibao He, Vijay T John, Damir B Khismatullin
High-intensity focused ultrasound (HIFU) can locally ablate biological tissues such as tumors, i.e., induce their rapid heating and coagulative necrosis without causing damage to surrounding healthy structures. It is widely used in clinical practice for minimally invasive treatment of prostate cancer. Nonablative, low-power HIFU was established as a promising tool for triggering the release of chemotherapeutic drugs from temperature-sensitive liposomes (TSLs). In this study, we combine ablative HIFU and thermally triggered chemotherapy to address the lack of safe and effective treatment options for elderly patients with high-risk localized prostate cancer...
September 6, 2016: Molecular Pharmaceutics
Akira Horiuchi, Satoru Muto, Shigeo Horie
BACKGROUND: To evaluate the efficacy of holmium laser enucleation of the prostate (HoLEP) followed by high-intensity focused ultrasound (HIFU) for patients with huge prostate adenoma and localized prostate cancer (CaP) and compare the morbidity and efficacy results with those observed in a similar population treated only with HIFU for a follow-up period of up to 5 years. METHODS: The present retrospective study included 30 CaP patients who underwent HIFU alone and 10 patients who underwent HoLEP followed by HIFU...
June 2016: Prostate International
Mark D Tyson, David F Penson, Matthew J Resnick
The primary goal of modern prostate cancer treatment paradigms is to optimize the balance of predicted benefits associated with prostate cancer treatment against the predicted harms of therapy. However, given the limitations in the existing evidence as well as the significant tradeoffs posed by each treatment, there remain myriad challenges associated with individualized prostate cancer treatment decision-making. In this review, we summarize the existing comparative effectiveness evidence of treatments for localized prostate cancer with an emphasis on oncologic control...
April 28, 2016: Urologic Oncology
Justin Lee, Georges Farha, Ian Poon, Irene Karam, Kevin Higgins, Samuel Pichardo, Kullervo Hynynen, Danny Enepekides
BACKGROUND: Radiotherapy is a critical component of the multidisciplinary management of cancers of the head and neck. It may comprise the primary curative treatment modality or is used in an adjuvant setting to improve local control and survival by preventing seeding and reseeding of distant metastases from persistent reservoirs of locoregional disease. Although considerable advances have been made recently in the fields of radiotherapy, systemic treatment and surgery for head and neck tumours, locoregional recurrence rates remain high and treatment side effects may have severe impact on patients' quality of life...
2016: Journal of Therapeutic Ultrasound
Louise Dickinson, Manit Arya, Naveed Afzal, Paul Cathcart, Susan C Charman, Andrew Cornaby, Richard G Hindley, Henry Lewi, Neil McCartan, Caroline M Moore, Senthil Nathan, Chris Ogden, Raj Persad, Jan van der Meulen, Shraddha Weir, Mark Emberton, Hashim U Ahmed
BACKGROUND: High-intensity focused ultrasound (HIFU) is a minimally-invasive treatment for nonmetastatic prostate cancer. OBJECTIVE: To report medium-term outcomes in men receiving primary whole-gland HIFU from a national multi-centre registry cohort. DESIGN, SETTING, AND PARTICIPANTS: Five-hundred and sixty-nine patients at eight hospitals were entered into an academic registry. INTERVENTION: Whole-gland HIFU (Sonablate 500) for primary nonmetastatic prostate cancer...
March 4, 2016: European Urology
A Aggarwal, J Nossiter, P Cathcart, J van der Meulen, J Rashbass, N Clarke, H Payne
AIMS: The National Prostate Cancer Audit (NPCA) started in April 2013 with the aim of assessing the process of care and its outcomes in men diagnosed with prostate cancer in England and Wales. One of the key aims of the audit was to assess the configuration and availability of specialist prostate cancer services in England. MATERIALS AND METHODS: In 2014, the NPCA undertook an organisational survey of all 143 acute National Health Service (NHS) Trusts and 48 specialist multidisciplinary team (MDT) hubs cross England...
August 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Yi-Hsuan Hsiao, Shou-Jen Kuo, Horng-Der Tsai, Ming-Chih Chou, Guang-Perng Yeh
The treatment of cancer is an important issue in both developing and developed countries. Clinical use of ultrasound in cancer is not only for the diagnosis but also for the treatment. Focused ultrasound surgery (FUS) is a noninvasive technique. By using the combination of high-intensity focused ultrasound (HIFU) and imaging method, FUS has the potential to ablate tumor lesions precisely. The main mechanisms of HIFU ablation involve mechanical and thermal effects. Recent advances in HIFU have increased its popularity...
2016: Journal of Cancer
Adam L Holtzman, Bradford S Hoppe, Haley P Letter, Curtis Bryant, Romaine C Nichols, Randal H Henderson, William M Mendenhall, Christopher G Morris, Christopher R Williams, Zuofeng Li, Nancy P Mendenhall
PURPOSE: Local recurrence of prostate cancer after cryosurgery (CS) and high-intensity focused ultrasound (HIFU) is an emerging problem for which optimal management is unknown. Proton therapy (PT) may offer advantages over other local therapeutic options. This article reviews a single institution's experience using PT for salvage of local recurrent disease after HIFU or CS. METHODS AND MATERIALS: We reviewed the medical records of 21 consecutive patients treated with salvage PT following a local recurrence of prostate cancer after CS (n=12) or HIFU (n=9) between January 2007 and July 2014...
May 1, 2016: International Journal of Radiation Oncology, Biology, Physics
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