Local recurrence of prostate cancer after external beam radiotherapy: early experience of salvage therapy using high-intensity focused ultrasonography

Gelet, A.; Chapelon, Jean Yves; Poissonnier, L.; Bouvier, Raymonde; Rouvière, Olivier; Curiel, Laura; Janier, Marc; Vallancien, Guy

doi:10.1016/j.urology.2004.01.002

Cited by 220 publications

(115 citation statements)

References 9 publications

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“…Eighty percent then had a negative biopsy post treatment, and 61% achieved a PSA nadir <0.5 ngm/ml. Median follow-up at this time is just 14.8 months, and only 44% of the patients show no evidence of disease progression [40].…”

Section: Discussionmentioning

confidence: 92%

When Prostate Brachytherapy Fails: A Case Report and Discussion

2005

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For appropriately selected brachytherapy patients, prostate-specific antigen failure is uncommon. Our patient experienced biochemical failure after 1 2 5 I brachytherapy treatment for low-risk prostate adenocarcinoma. We suggest neoadjuvant/ adjuvant hormonal therapy combined with pelvic external-beam radiation therapy as a reasonable salvage treatment. At the 2-year follow-up, he is apparently doing well. With limited data available, salvage management for this situation is presently investigational. The Oncologist 2005;10:799-805

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Section: Discussionmentioning

confidence: 92%

When Prostate Brachytherapy Fails: A Case Report and Discussion

2005

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“…4). Detectamos hasta 7 puntos de corte distintos de PSA publicados en los últimos años por autores de primera línea 1,[18][19][20] . Esto supone un grave problema en dos aspectos: en primer lugar, la interpretación del resultado de los seguimientos.…”

Section: Resultados De La Técnica Escenarios Clínicos Actualesunclassified

Estado actual del ultrasonido de alta frecuencia (HIFU) en el tratamiento del adenocarcinoma prostático

García

Rascón

Amo

et al. 2007

Actas Urológicas Españolas

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RESUMENESTADO ACTUAL DEL ULTRASONIDO DE ALTA FRECUENCIA (HIFU) EN EL TRATAMIENTO DEL ADENOCARCINOMA PROSTÁTICO Objetivo. Evaluar el estado actual de la utilización del Ultrasonido de Alta Intensidad (HIFU) en el tratamiento del adenocarcinoma prostático (Cap).Método. Hemos llevado a cabo una revisión del papel actual del HIFU en el tratamiento del Cap.Resultados. La tecnología HIFU está actualmente siendo aplicada ya de forma habitual en Europa en el tratamiento del Cap. Las indicaciones principales en la actualidad son dos: la aplicación del HIFU como primer escalón terapéutico y como terapia de rescate en recidivas post-radioterapia. Los trabajos actuales están basados en equipos clínicos en desarrollo. Aunque las últimas publicaciones sugieren que HIFU es una forma de tratamiento útil para el Cap bien y moderadamente diferenciado, existe todavía falta de comparaciones de esta terapia menos invasiva con los tratamientos estándar. Seguimos detectando en los trabajos disparidad en la definición de supervivencia libre de enfermedad (SLE), lo que dificulta la interpretación de resultados y la extracción de conclusiones definitivas.Conclusiones. La experiencia de los grupos de trabajo especializados en HIFU es altamente prometedora. Entre los aspectos a destacar está su gran capacidad de destrucción tumoral local tanto en los casos primarios como en las recidivas post-radioterapia. Para extraer conclusiones a medio y largo plazo debemos generar ensayos clí-nicos randomizados y controlados con seguimiento suficiente para medir beneficios en términos de supervivencia global y calidad de vida (balance efectos adversos / beneficios), realizar comparaciones con las terapias estándar y homogeneizar los criterios de definición de la SLE.Palabras clave: Ultrasonido de alta frecuencia (HIFU). Adenocarcinoma prostático. ABSTRACT CURRENT STATE OF HIGH INTENSITY FOCUSED ULTRASOUND (HIFU) AS TREATMENT OF PROSTATICCARCINOMA Objective. To evaluate the current state of high intensity focused ultrasound as therapeutical option of prostatic carcinoma (PCa) Methods. We completed an extense review of urologic literature on the role of HIFU on the treatment of PCa.Results. This technique is nowadays usually being indicated in Europe as treatment of many cases of either primary or relapsed PCa after radiotherapy. Although some reports suggest that HIFU is very effective as treatment for low and medium risk localized PCa patients, no randomized series comparing this technique with conventional therapies have been presented yet. Great disparity in criteria to define free-disease survival is detected, which make difficult the interpretation of results.Conclusions. Experience of some groups in HIFU is highly promising. Local tumour destruction is evident both in primary and relapsed PCa cases. To make conclusions in the long-term, controlled-randomized trials must be designed, with follow-up to measure benefits in global survival and quality of live. Comparisons must be completed with conventional techniques, and a uniform definition of dis...

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“…In conventional HIFU treatments [4], a duty cycle of typically 50% is applied between exposures (5 seconds) and cooling (5 seconds). The new geometry of transducer described in this study allows performing ultrasound exposure continuously since each transducer is excited alternatively.…”

Section: Discussionmentioning

confidence: 99%

“…The focused energy, after being absorbed by tissues for only a few seconds, can induce high temperatures (typically >60°C) and generate irreversible tissue necrosis at the target region while not damaging surrounding tissues. Excellent results have been obtained (both experimentally and clinically) at inducing homogeneous and reproducible tumor destruction by thermal coagulation necrosis [4][5][6][7]. The main technical limitation to widespread clinical use of HIFU has been the long time required to treat tumors of several cubic centimeter volumes.…”

Section: Introductionmentioning

confidence: 99%