High-intensity focused ultrasound (HIFU) is a rapidly maturing technology with diverse clinical applications. In the field of oncology, the use of HIFU to non-invasively cause tissue necrosis in a defined target, a technique known as focused ultrasound surgery (FUS), has considerable potential for tumour ablation. In this article, we outline the development and underlying principles of HIFU, overview the limitations and commercially available equipment for FUS, then summarise some of the recent technological advances and experimental clinical trials that we predict will have a positive impact on extending the role of FUS in cancer therapy.
A patient with primary adenocarcinoma with yolk sac and trophoblastic differentiation occurring in Barrett's esophagus is reported. Yolk sac differentiation at this site has not been described previously. The diagnosis of germ cell differentiation initially was suggested by the finding of elevated serum tumor marker levels. The patient experienced disease remission after cytotoxic chemotherapy. Germ cell differentiation may be difficult to identify in small biopsy samples, which may not be representative of the tumor as a whole. The finding of germ cell differentiation defines therapy and predicates for a relatively good prognosis, which is in contrast to adenocarcinoma. Because of the significance of germ cell differentiation in the selection of appropriate therapy, immunostaining for germ cell tumor markers is suggested in all patients with adenocarcinoma who are younger than 50 years.
Objectives: To determine the cost-effectiveness of cabazitaxel, based mainly on the TROPIC trial in 2nd line treatment of mHRPC relative to the standard of care at the time of launch of the drug. MethOds: A Markov model was developed to comprise set of different health states each associated with costs, effects and probabilities of moving to other state. In simulation, a cohort of defined patients are run through the model during the time period of choice, it's assumed that transitions between states only occurs at equidistant time-points and the interval is called a cycle. Because of the relatively short survival time of mHRPC patients, cycle length in the model was set at 3 weeks, corresponding to the length of one chemotherapy administration cycle. Transition rates between different states representing mHRPC disease progression were estimated based on progression of disease and survival rates from the TROPIC trial. Results: According to the approved labeling in Turkey, a subgroup of patients with ECOG PS 0-1 and measurable disease at baseline was identified on TROPIC results with a secondary analysis. The result of this analysis shows a similar OS outcomes with decreased death rates. Cabazitaxel was costeffective compared mitoxantrone with cost per LYG of TRY66,862 given the threshold of TRY68,409 per LYG for the subgroup of the patients at ECOG PS 0-1 and with measurable disease at baseline. Although there has been no formal threshold for the cost-effectiveness ratio in Turkey, a threshold of TRY68,409 per LY gained was assumed based on WHO-CHOICE criteria (3xGDP percapita). cOnclusiOns: It is difficult for the results of the analysis to be interpreted because there is no official cost-effectiveness threshold in Turkey. However, from the WHO perspective; results showed that cabazitaxel is a cost-effective treatment with all ICER values compared to mitoxantrone, below TRY68,409.Objectives: Gene expression profiling (GEP) and expanded immunohistochemistry (IHC) tests aim to improve decision-making relating to adjuvant chemotherapy for women with early breast cancer (EBC) at intermediate or high risk of recurrence following primary surgery. MethOds: A probabilistic model was developed to evaluate the cost effectiveness of treatment guided using the OncotypeDx and IHC4 tests compared with current clinical practice in England and Wales. Analysis was undertaken for women with oestrogen receptor positive (ER+), lymph node negative (LN-), and HER2-EBC from a NHS perspective. In the comparator arm, cancer registry data was used to inform the proportion of patients receiving chemotherapy under current practice. In the intervention arm (new test in addition to current practice) patients were classified into different risk categories based on the result of the new test. The likelihood of receiving chemotherapy was dependent on this classification. The natural history of breast cancer was then simulated using a state transition Markov model, taking into account the reduction in the risk of recurrence associated with chemo...
High-intensity focused ultrasonography is the only completely non-invasive thermal therapy. To date its applications have been limited but clinical indications are expanding with enhanced technological advances that have increased the accuracy of targeting and decreased the duration of treatment times. We report its first use for rectal cancer.Ann R Coll Surg Engl 2011; 93: e119-e121 doi 10.1308/147870811X592458Locally recurrent rectal cancer can give rise to unpleasant symptoms such as tenesmus, mucus discharge and bleeding. Symptom progression usually results in deterioration of quality of life, especially following failure of conventional treatment options such as radiotherapy and cytotoxic chemotherapy. There is a clear and unmet need for new therapeutic options in this situation.High-intensity focused ultrasonography (HIFU) is a novel non-invasive ablative technology. By delivering high-power ultrasound waves to a small focal area, temperatures above 60C (usually 80-90C) can be reached. This results in coagulative necrosis and cavitation.
IntroductionHigh-intensity focused ultrasound (HIFU) is an ablative treatment undergoing assessment for the treatment of benign and malignant disease. We describe the first reported intracavitary HIFU ablation for recurrent, unresectable and symptomatic cervical cancer.Case descriptionA 38 year old woman receiving palliative chemotherapy for metastatic cervical adenocarcinoma was offered ablative treatment from an intracavitary trans-rectal HIFU device (Sonablate® 500). Pre-treatment symptoms included vaginal bleeding and discharge that were sufficient to impede her quality of life. No peri-procedural adverse events occurred. Symptoms resolved completely immediately post-procedure, reappeared at 7 days, increasing to pre-procedural levels by day 30.Discussion and evaluationThis first time experience of intracavitary cervical HIFU suggests that it is feasible for palliation of advanced cervical cancer, with no early evidence of unexpected toxicity. Ethical approval had also been granted for the use of per-vaginal access if appropriate. This route, alone or in combination with the rectal route, may provide increased accessibility in future patients with a redesigned device more suited to trans-vaginal ablations.ConclusionIntracavitary HIFU is a potentially safe procedure for the treatment of cervical cancer and able to provide symptomatic improvement in the palliative setting.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.