High Intensity Focused Ultrasound for Radiorecurrent Prostate Cancer: A North American Clinical Trial

Jones, Tonye A.; Chin, Joseph L.; McLeod, David G.; Barkin, Jack; Marks, Leonard S.

doi:10.1016/j.juro.2017.06.078

Cited by 31 publications

(12 citation statements)

References 15 publications

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“…Neither Gleason score nor positive biopsy percentage influenced RFS. Another study by Jones et al of 100 patients at least 2 years after EBRT who received whole gland HIFU, 50 men achieved their 1 year endpoint of PSA nadir less than 0.5ng/mL and a negative biopsy (17).…”

Section: Discussionmentioning

confidence: 97%

High-intensity focused ultrasound (HIFU) as salvage therapy for radio-recurrent prostate cancer: Predictors of disease response.

Dason

Allard

Hoogenes

et al. 2016

JCO

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ARTICLE INFO ______________________________________________________________ ______________________Background: Some men with localized radio-recurrent prostate cancer may benefit from salvage high-intensity focused ultrasound (HIFU). Herein, we describe oncologic outcomes and predictors of disease response after salvage whole gland HIFU from our prospective cohort. Materials and Methods:Patients with localized radio-recurrent prostate cancer were prospectively enrolled from January 2005 to December 2014. Participants had to meet both biochemical and histological definitions of recurrence. Exclusion criteria included the receipt of prior salvage therapy, presence of metastatic disease, and administration of ADT in the 6-months prior to enrollment. Participants were treated with a single session of whole-gland HIFU ablation with the Ablatherm TM device (EDAP, France). The primary endpoint was recurrence-free survival (RFS), defined as a composite endpoint of PSA progression (Phoenix criteria), receipt of any further salvage therapy, receipt of ADT, clinical progression, or death. Kaplan-Meier survival analysis was used to determine the primary end-point and stratifications were used to determine the significance of 6 pre-specified predictors of improved RFS (TRUS biopsy grade, number of study entry TRUS biopsy cores positive, palpable disease at study enrollment, pre-HIFU PSA, an undetectable post-HIFU PSA nadir, and receipt of prior hormone therapy). Survival analysis was performed on participants with a minimum of 1-year follow-up. Results: Twenty-four participants were eligible for study inclusion with a median follow-up of 31.0 months. Median PSA at study entry was 4.02ng/ml. Median time to PSA nadir was 3 months after treatment and median post-HIFU PSA nadir was 0.04ng/ ml. Median 2-year and 5-year RFS was 66.3% and 51.6% respectively. Of our 6 prespecified predictors, an undetectable PSA nadir was the only significant predictor of improved RFS (HR 0.07, 95% CI 0.02-0.29, log-rank P<0.001). One participant underwent an intervention for a urethral stricture. No participants developed osteitis pubis or rectourethral fistulae. Conclusions: Salvage HIFU allows for disease control in selected patients with localized radio-recurrent prostate cancer. An undetectable PSA nadir serves as an early predictor of disease response.

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Section: Discussionmentioning

confidence: 97%

High-intensity focused ultrasound (HIFU) as salvage therapy for radio-recurrent prostate cancer: Predictors of disease response.

Dason

Allard

Hoogenes

et al. 2016

JCO

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“…Chapelon et al reported that salvage HIFU therapy after field external beam radiation therapy was increasing, and outcomes were similar to those achieved at surgery, with the advantage of fewer adverse effects, including urinary tract infections, bladder neck strictures, rectourethral fistulas, and osteitis pubis . Jones et al had similar results using whole‐gland HIFU. In a study of 49 patients using a posttreatment prostate‐specific antigen nadir of 0.2 ng/mL as a cutoff value to define biochemical recurrence, Fomkin et al recommended that external beam radiation therapy could be used for salvage therapy after HIFU.…”

Section: High‐intensity Focused Us In the Treatment Of Recurrencementioning

confidence: 93%

Histotripsy: The Next Generation of High‐Intensity Focused Ultrasound for Focal Prostate Cancer Therapy

Dubinsky

Khokhlova

et al. 2019

J of Ultrasound Medicine

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This article reviews the most current methods and technological aspects of highintensity focused ultrasound (HIFU), which is termed histotripsy. The rationale for focal therapy for prostate carcinoma rather than prostatectomy, which is being used extensively throughout Europe and Asia, is presented, and an argument for why HIFU is the modality of choice for primary therapy and recurrent disease is offered. The article presents a review of the technical advances including higher ultrasound beam energy than current thermal HIFU which allows for more accurate tissue targeting, less collateral tissue damage, and faster treatment times. Finally, the article presents a discussion about the advantage of ultrasound guidance for histotripsy in preference to magnetic resonance imaging guidance primarily based on cost, ease of application, and portability.

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“…Steering capabilities of an acoustic lens for transcranial therapy: numerical and experimental studies Guillaume Maimbourg 1,2,3,4 , Alexandre Houdouin 1,2,3 , Thomas Deffieux 1,2,3 , Mickael Tanter 1,2,3 and Jean-François Aubry A single-element transducer with a 61mm radius of curvature and a 67mm aperture (H101 MR, Sonic Concepts, Bothell, USA) was used to achieve transcranial focusing. It was operated at its resonance frequency (914kHz), which was determined from the analysis of its complex impedance against frequency, using a vector network analyzer (ZVL, Rohde & Schwarz, Munich, Germany).…”

Section: A Transducermentioning

confidence: 99%

“…Focused ultrasound therapies have seen clinical applications for a growing number of pathologies: prostate [1,2] or pancreatic [3,4] cancers, bone metastases [5,6], uterine fibroids [7][8][9], or essential tremor [10][11][12]. It complements or even advantageously replaces surgery-based conventional methods.…”

Section: Introductionmentioning

confidence: 99%

Steering Capabilities of an Acoustic Lens for Transcranial Therapy: Numerical and Experimental Studies

Maimbourg

Houdouin

Thomas

et al. 2020

IEEE Trans. Biomed. Eng.

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Brain therapy by transcranial focused ultrasound needs to compensate for the delays locally induced by the skull. The patient-specific phase profile is currently generated by a multi-element array with a growing number of elements. We recently introduced a disruptive approach, consisting in using a single element transducer coupled to an acoustic lens of controlled thickness: by adjusting the local thickness of the lens, we were able to induce a phase difference which compensated that of the skull. Nevertheless, such an approach suffers from an apparent limitation: the lens is a priori designed for one specific target. In this paper, we demonstrate the possibility of taking advantage of the isoplanatic angle of the aberrating skull in order to steer the focus by mechanically moving the transducer/acoustic lens pair around its initial focusing position. This study, conducted on three human skull samples, confirms that tilting of the transducer with the lens restores a single focus at 914 kHz for a steering up to 11mm in the transverse direction, and 10mm in the longitudinal direction, around the initial focal region. Acoustic lens, transcranial ultrasound, therapeutic ultrasound

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High Intensity Focused Ultrasound for Radiorecurrent Prostate Cancer: A North American Clinical Trial

Cited by 31 publications

References 15 publications

High-intensity focused ultrasound (HIFU) as salvage therapy for radio-recurrent prostate cancer: Predictors of disease response.

High-intensity focused ultrasound (HIFU) as salvage therapy for radio-recurrent prostate cancer: Predictors of disease response.

Histotripsy: The Next Generation of High‐Intensity Focused Ultrasound for Focal Prostate Cancer Therapy

Steering Capabilities of an Acoustic Lens for Transcranial Therapy: Numerical and Experimental Studies

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