Energy-based ablative therapy of prostate cancer: high-intensity focused ultrasound and cryoablation

Marberger, Michael

doi:10.1097/mou.0b013e3280dd8a65

Cited by 17 publications

(5 citation statements)

References 42 publications

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“…[44]. Therefore, if an adequate PSA nadir (≤0.5 ng/mL) is not reached within 3–4 months, HIFU therapy is probably failing and repeat HIFU or a change in therapy should be considered [49].…”

Section: Discussionmentioning

confidence: 99%

High‐intensity focused ultrasound in prostate cancer; a systematic literature review of the French Association of Urology

Rébillard¹,

Soulié²,

Chartier‐Kastler

et al. 2008

BJU International

103

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antigen (PSA) level of ≤ 28 ng/mL and a prostate volume of ≤ 40 mL. Negative biopsy rates with the Ablatherm TM device (EDAP TMS S.A., Vaulx-en-Velin, France) were 64-93%, and a PSA nadir of ≤ 0.5 ng/mL was achieved in 55-84% of patients. The 5-year actuarial disease-free survival rates were 60-70%. The most common complications were stress urinary incontinence, urinary tract infection, urethral/bladder neck stenosis or strictures, and erectile dysfunction. For the Ablatherm device, the rate of complications has been significantly reduced over the years, due to technical improvements in the device and the use of transurethral resection of the prostate before HIFU. In conclusion, HIFU as primary therapy for prostate cancer is indicated in older patients ( ≥ 70 years) with T1-T2 N0M0 disease, a Gleason score of < 7, a PSA level of < 15 ng/mL and a prostate volume of < 40 mL. In these patients HIFU achieves short-term cancer control, as shown by a high percentage of negative biopsies and significantly reduced PSA levels. The median-term survival data also seem promising, but long-term follow-up studies are needed to further evaluate cancerspecific and overall survival rates before the indications for primary therapy can be expanded.

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Section: Discussionmentioning

confidence: 99%

High‐intensity focused ultrasound in prostate cancer; a systematic literature review of the French Association of Urology

Rébillard¹,

Soulié²,

Chartier‐Kastler

et al. 2008

BJU International

103

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“…Energy‐based ablative techniques are of growing interest for today's heterogeneous spectrum of prostate cancer. At present, primary HIFU appears to be a valid alternative to active surveillance protocols in low‐risk cancers and, in older patients, to standard therapy [21]. HIFU is a technique that uses focused ultrasound (US) to generate areas of intense heat to destroy tissue.…”

Section: Introductionmentioning

confidence: 99%

High‐intensity focused ultrasound (HIFU) for definitive treatment of prostate cancer

et al. 2012

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What's known on the subject? and What does the study add? Novel therapeutic methods have emerged in recent years as ‘focal’ treatment alternatives in which cancer foci can be eradicated and greatly reducing the associated side‐effects of radical treatment. High‐intensity focused ultrasound (HIFU) seems to result in a well fitted technology, which has proven short‐ to medium‐term cancer control, with a low rate of complications comparable with those of established therapies. This is an up‐to‐date review of the available literature on HIFU as a definitive treatment of prostate cancer. It describes the technique in a comprehensive approach in terms of technical features, procedure, indications, and gives an overview of its historical background; finally, we present the future applications of HIFU and its development trend. OBJECTIVES To provide an up‐to‐date review of the available literature on high‐intensity focused ultrasound (HIFU) as a definitive treatment of prostate cancer. To present the technique in a comprehensive approach, comparing the available devices according to the existing evidence in terms of technical features, procedure, indications, and to give an overview of its historical background; and finally, to discuss future applications of HIFU and its development trend. MATERIALS AND METHODS A systematic literature search was conducted using MEDLINE and EMBASE via Ovid databases (January 2000 to December 2011), to identify studies on HIFU for treatment of prostate cancer. Only English‐language and human‐based full manuscripts that reported on case series studies with >50 participants, patient characteristics, efficacy and safety data were included. RESULTS No randomised controlled trials were identified by the literature search. We identified 31 uncontrolled studies that examined the efficacy of HIFU as primary treatment and two studies that examined the efficacy of HIFU as salvage treatment. Most treated patients had localised prostate cancer (stage T1–T2); Gleason scores of 2–10 and mean prostate specific antigen (PSA) values of 4.6–12.7 ng/mL. The mean age range of the patients was 64.1–72 years. The mean follow‐up ranged from 6.4 to 76.8 months. Negative biopsy rates ranged from 35 to 95%. PSA nadirs ranged from 0.04 to 1.8 ng/mL. The 5‐year disease‐free survival rates ranged from 61.2 to 95%; 7‐ and 8‐year disease free survival rates ranged from 69 to 84%. The most common complications associated with the HIFU procedure as the primary treatment included: urinary retention (<1–20%); urinary tract infections (1.8–47.9%); stress or urinary incontinence (<1–34.3%); and erectile dysfunction (20–81.6%). Recto‐urethral fistula was reported in <2% of patients. Treatment‐related morbidity appeared to be reduced by the combination of transurethral resection (TURP) of the prostate and HIFU. CONCLUSIONS Novel therapeutic methods have emerged in recent years as ‘focal’ treatment alternatives, in which cancer foci could be eradicated by greatly reducing the associated side‐effects of radical treatment. ...

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“…Similarly, radiofrequency induced hyperthermia has been used in the treatment of prostate tumors through intracavitary applicators (Bhowmick et al 2001; Dawkins et al 1997; Sofras et al 1996; Zargar Shoshtari et al 2006). The main challenge with the intracavitary or intraluminal delivery of hyperthermia is the generation of adequate heat in the prostate without excessive temperature in critical adjacent structures such as the neurovascular bundle, urethra, bladder and rectum (Gillett et al 2004; Marberger 2007). Alternatively, external regional hyperthermia can be used in combination with RT for the treatment of prostate cancer (Anscher et al 1997).…”

Section: Hyperthermia For Prostate Cancermentioning

confidence: 99%

Nanoparticle-mediated thermal therapy: Evolving strategies for prostate cancer therapy

Krishnan

Diagaradjane

Cho

2010

International Journal of Hyperthermia

132

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Purpose Recent advances in nanotechnology have resulted in the manufacture of a plethora of nanoparticles with different sizes, shapes, core physicochemical properties and surface modifications that are being investigated for potential medical applications, particularly for the treatment of cancer. This review focuses on the therapeutic use of customized gold nanoparticles, magnetic nanoparticles and carbon nanotubes that efficiently generate heat upon electromagnetic (light and magnetic fields) stimulation after direct injection into tumors or preferential accumulation in tumors following systemic administration. This review will also focus on the evolving strategies to improve the therapeutic index of prostate cancer treatment using nanoparticle-mediated hyperthermia. Conclusions Nanoparticle-mediated thermal therapy is a new and minimally invasive tool in the armamentarium for the treatment of cancers. Unique challenges posed by this form of hyperthermia include the non-target biodistribution of nanoparticles in the reticuloendothelial system when administered systemically, the inability to visualize or quantify the global concentration and spatial distribution of these particles within tumors, the lack of standardized thermal modeling and dosimetry algorithms, and the concerns regarding their biocompatibility. Nevertheless, novel particle compositions, geometries, activation strategies, targeting techniques, payload delivery strategies, and radiation dose enhancement concepts are unique attributes of this form of hyperthermia that warrant further exploration. Capitalizing on these opportunities and overcoming these challenges offers the possibility of seamless and logical translation of this nanoparticle-mediated hyperthermia paradigm from the bench to the bedside.

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Energy-based ablative therapy of prostate cancer: high-intensity focused ultrasound and cryoablation

Cited by 17 publications

References 42 publications

High‐intensity focused ultrasound in prostate cancer; a systematic literature review of the French Association of Urology

High‐intensity focused ultrasound in prostate cancer; a systematic literature review of the French Association of Urology

High‐intensity focused ultrasound (HIFU) for definitive treatment of prostate cancer

Nanoparticle-mediated thermal therapy: Evolving strategies for prostate cancer therapy

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