Principles and results of high-intensity focused ultrasound for localized prostate cancer

Colombel, M.; Gelet, A.

doi:10.1038/sj.pcan.4500721

Cited by 41 publications

(26 citation statements)

References 14 publications

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“…1 With an actuarial 5-year disease-free survival rate at 66%, most authors still report 6-17% residual cancerous tissue in the patients treated. [2][3][4] The persistence of tumor cells after treatment is most often explained by the presence of a locally advanced understaged prostate cancer with extracapsular extensions, and given that the HIFU treatment is localized in the prostate these extraprostatic cells are therefore not destroyed.…”

Section: Introductionmentioning

confidence: 99%

Influence of the docetaxel administration period (neoadjuvant or concomitant) in relation to HIFU treatment on the growth of Dunning tumors: results of a preliminary study

Paparel

Chapelon

Bissery

et al. 2007

Prostate Cancer Prostatic Dis

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The objective of this study was to evaluate mechanisms of the synergy between high intensityfocused ultrasound (HIFU) and docetaxel and to determine the best sequence of chemotherapy administration in relation to HIFU treatment for obtaining optimum control of tumoral growth. A total of 15 days after s.c. implantation of the tumor, 52 Copenhagen rats studied were randomized in 4 groups of 13: controls, docetaxel alone (group 1), HIFU and docetaxel concomitant (group 2) and HIFU and docetaxel administered 24 h before treatment (group 3). The number of HIFU shots was calculated in order to cover 75% of the tumor volume. The effects of docetaxel, HIFU and their interaction on tumor volumes were analyzed using a linear regression. The distributions of the tumor volumes were significantly greater in the control group than in the group 1 (P ¼ 0.002) and than in both groups 2 and 3 (Po0.0001 and P ¼ 0.0001). These volumes were also significantly greater in group 1 than in both groups 2 and 3 and there was no difference between the groups 2 and 3. The tumor doubling times were 7.8 days for the group 1, 43.8 days for the group 2, 16.1 days for the group 3 and 5.9 days for the controls. The mechanism of the synergy between HIFU and docetaxel on the growth of Dunning tumors is apparently multifaceted. The results are encouraging because in the two groups of rats treated with the combination of HIFU and docetaxel, the percentage of complete remission was approximately 30%.

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Section: Introductionmentioning

confidence: 99%

Influence of the docetaxel administration period (neoadjuvant or concomitant) in relation to HIFU treatment on the growth of Dunning tumors: results of a preliminary study

Paparel

Chapelon

Bissery

et al. 2007

Prostate Cancer Prostatic Dis

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“…Whole-gland treatment is achievable while sparing the neurovascular bundles and external urethral sphincter [1,2]. As a result, reported rates of urinary and sexual morbidity are lower and quality of life higher following HIFU therapy than following radical prostatectomy [3].…”

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confidence: 99%

Prostatic cancer surveillance following whole-gland high-intensity focused ultrasound: comparison of MRI and prostate-specific antigen for detection of residual or recurrent disease

Punwani¹,

Emberton²,

Walkden³

et al. 2012

BJR

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Objective: This retrospective study compares dynamic contrast-enhanced (DCE) MRI with the serial prostate-specific antigen (PSA) measurement for detection of residual disease following whole-gland high-intensity focused ultrasound (HIFU) therapy of prostate cancer. Methods: Patients in whom post-HIFU DCE-MRI was followed within 3 months by ultrasound-guided transrectal biopsy were selected from a local database. 26 patients met the study inclusion criteria. Serial PSA levels following HIFU and post-HIFU followup MRI were retrieved for each patient. Three radiologists unaware of other investigative results independently assessed post-HIFU MRI studies for the presence of cancer, scoring on a four-point scale (1, no disease; 2, probably no disease; 3, probably residual disease; and 4, residual disease). Sensitivity, specificity and receiver operating characteristic (ROC) analysis were performed for each reader, post-HIFU PSA nadir and pre-biopsy PSA level thresholds of .0.2 and .0.5 ng ml 21. Results:The sensitivity of DCE-MRI for detection of residual disease for the three readers ranged between 73% and 87%, and the specificity between 73% and 82%. There was good agreement between readers (k50.69-0.77). The sensitivity and specificity of PSA thresholds was 60-87% and 73-100%, respectively. The area under the ROC curve was greatest for pre-biopsy PSA (0.95). Conclusion: DCE-MRI performed following whole-gland HIFU has similar sensitivity and specificity and ROC performance to serial PSA measurements for detection of residual or recurrent disease.

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“…Fistulas may be due to impairment of the rectal wall by cavitation and temperature elevation. 12 Five cases of rectal fistula have been reported in patients who had previously undergone brachytherapy and/or radiotherapy. 5,13 Rectal fistulas can be prevented by monitoring rectal wall thickness (o6 mm), better knowledge of heat diffusion and better real-time control of the HIFU shots and of the cooling system.…”

Section: Discussionmentioning

confidence: 99%

Transrectal high-intensity focused ultrasound (HIFU) treatment of localized prostate cancer: review of technical incidents and morbidity after 5 years of use

Ripert

Azemar

Menard

et al. 2010

Prostate Cancer Prostatic Dis

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The objective of this study was to report on technical incidents and early and late complications occurring in high-intensity focused ultrasound (HIFU) treatment of patients with localized prostate cancer. We performed a retrospective review of patients who were treated by Ablatherm at our centre. We recorded all technical incidents, treatment discontinuations and early (o1 month) and late complications. A total of 74 HIFU procedures were performed in 65 patients (55 first-line HIFU treatments and 10 cases of salvage therapy after radiotherapy) over a 5-year period. Median followup was 41 months (10-64 months). All the procedures were well tolerated and no intra-or perioperative deaths occurred. Six technical incidents in the overall population (8.1%) led to discontinuation of the procedure. The early complication rate in patients undergoing first-line HIFU was 36.4%: urinary retention (20%), dysuria (5.4%), urinary infection (3.6%), haematuria (3.6%) and urethral stenosis (3.6%). The late complication rate was 12.7%: urethral stenosis (9%) and dysuria (3.6%). There were no cases of rectourethral fistula. The long-term urinary incontinence rate was 20% and the de novo erectile dysfunction rate was 77.1%. Nine complications (16.4%) required surgical management. The overall complication rate was 49%. Ablatherm is a reliable technique with a relatively high complication rate. However, most complications were minor and required surgical management in a few cases only. Our results confirm that all patients who are offered HIFU treatment should be properly informed of the risks, in particular with regard to continence and sexual function.

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Principles and results of high-intensity focused ultrasound for localized prostate cancer

Cited by 41 publications

References 14 publications

Influence of the docetaxel administration period (neoadjuvant or concomitant) in relation to HIFU treatment on the growth of Dunning tumors: results of a preliminary study

Influence of the docetaxel administration period (neoadjuvant or concomitant) in relation to HIFU treatment on the growth of Dunning tumors: results of a preliminary study

Prostatic cancer surveillance following whole-gland high-intensity focused ultrasound: comparison of MRI and prostate-specific antigen for detection of residual or recurrent disease

Transrectal high-intensity focused ultrasound (HIFU) treatment of localized prostate cancer: review of technical incidents and morbidity after 5 years of use

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