Salvage focal cryosurgery may delay use of androgen deprivation therapy in cryotherapy and radiation recurrent prostate cancer patients

Kongnyuy, Michael; Berg, Courtney; Kosinski, Kaitlin E.; Habibian, David J.; Schiff, Jeffrey; Corcoran, Anthony; Katz, Aaron E.

doi:10.1080/02656736.2017.1306121

Cited by 14 publications

(28 citation statements)

References 22 publications

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“…Unfortunately, in this study, cryoablation was excluded [4]. In the SEER database, the use of cryotherapy increased fourfold from 2001 to 2005 especially for elderly patients, with the advantage of being minimally invasive and less costly [13], and cryoablation showed good results in primary [14] or salvage treatment [15,16]. In our study, the results underlined the important conclusion that cryoablation could be an alternative local treatment for a primary tumour and might exert a significant survival benefit in prostate cancer patients with bone metastases.…”

Section: Discussionmentioning

confidence: 99%

The oncologic results of cryoablation in prostate cancer patients with bone metastases

Zhi

Yang

et al. 2017

International Journal of Hyperthermia

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Section: Discussionmentioning

confidence: 99%

The oncologic results of cryoablation in prostate cancer patients with bone metastases

Zhi

Yang

et al. 2017

International Journal of Hyperthermia

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“…11,12,14 The result is unexpected, since salvage treatment is traditionally associated with poorer outcomes than primary therapy. 25 Interpretation is limited due to sample size, but MR-guided wholegland CA may potentially optimize local control, postpone use of androgen deprivation therapy (and its side-effects), 33 and offer similar complication rates to alternative therapies in these challenging second-line cases. Focal CA is increasingly utilized for radio-recurrent disease, 30 due to potentially lower complication rates, preserved sexual function, and satisfactory local control compared with wholegland ablation.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous MR-guided whole-gland prostate cancer cryoablation: safety considerations and oncologic results in 30 consecutive patients

Marini¹,

Cazzato²,

Garnon³

et al. 2019

The British Journal of Radiology

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Prostate cancer (PCa) is the most common malignant tumor in males, accounting for almost 1 in 5 new cancer diagnoses in the USA. 1 Despite recent reductions in age-standardized mortality, PCa remains the third most common cause of cancer-related mortality in males. 1,2 Standard curative treatment for prostate-confined disease includes radical prostatectomy and radiotherapy. 3 According to 2017 American Urological Association guidelines, whole-gland cryoablation (CA) is a third intention alternative curative therapy for patients unsuitable for standard treatments with good life expectancy (>10 years) and intermediate-risk disease (i.e. prostate specific antigen (PSA) 10.0-20.0 ng ml −1 , Gleason score = 7, cT2b-c); and may be offered to low-risk patients (PSA <10.0 ng ml −1 , Gleason Score <7, cT1c-T2a) following discussion of potential complications and absence of survival benefit compared with active surveillance. 4 CA has also been proposed as salvage therapy for patients with local recurrence following radical radiotherapy. 5 Several studies have established that whole-gland and focal CA for primary/radio-recurrent PCa provides acceptable

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“…Today, focal salvage treatment of radiorecurrent prostate cancer is performed with a variety of techniques: focal cryotherapy [72,73,74], focal HIFU [75], focal brachytherapy (both low-dose-rate [76,77] and high-dose-rate [78,79,80]), and, in smaller series, stereotactic body radiation therapy (SBRT) [81,82]. The extend of ablation differs per ablation method and between series, ranging from ultrafocal to hemi-ablation and subtotal ablation.…”

Section: Focal Treatment Of Radiorecurrent Prostate Cancermentioning

confidence: 99%

Focal Salvage Treatment of Radiorecurrent Prostate Cancer: A Narrative Review of Current Strategies and Future Perspectives

Son

Peters

Moerland

et al. 2018

Cancers

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Over the last decades, primary prostate cancer radiotherapy saw improving developments, such as more conformal dose administration and hypofractionated treatment regimens. Still, prostate cancer recurrences after whole-gland radiotherapy remain common, especially in patients with intermediate- to high-risk disease. The vast majority of these patients are treated palliatively with androgen deprivation therapy (ADT), which exposes them to harmful side-effects and is only effective for a limited amount of time. For patients with a localized recurrent tumor and no signs of metastatic disease, local treatment with curative intent seems more rational. However, whole-gland salvage treatments such as salvage radiotherapy or salvage prostatectomy are associated with significant toxicity and are, therefore, uncommonly performed. Treatments that are solely aimed at the recurrent tumor itself, thereby better sparing the surrounding organs at risk, potentially provide a safer salvage treatment option in terms of toxicity. To achieve such tumor-targeted treatment, imaging developments have made it possible to better exclude metastatic disease and accurately discriminate the tumor. Currently, focal salvage treatment is being performed with different modalities, including brachytherapy, cryotherapy, high-intensity focused ultrasound (HIFU), and stereotactic body radiation therapy (SBRT). Oncologic outcomes seem comparable to whole-gland salvage series, but with much lower toxicity rates. In terms of oncologic control, these results will improve further with better understanding of patient selection. Other developments, such as high-field diagnostic MRI and live adaptive MRI-guided radiotherapy, will further improve precision of the treatment.

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Salvage focal cryosurgery may delay use of androgen deprivation therapy in cryotherapy and radiation recurrent prostate cancer patients

Abstract: SFC may be used to delay the use of ADT. Further assessment of our findings with high-powered studies and longer follow-up is required.

Cited by 14 publications

References 22 publications

The oncologic results of cryoablation in prostate cancer patients with bone metastases

The oncologic results of cryoablation in prostate cancer patients with bone metastases

Percutaneous MR-guided whole-gland prostate cancer cryoablation: safety considerations and oncologic results in 30 consecutive patients

Focal Salvage Treatment of Radiorecurrent Prostate Cancer: A Narrative Review of Current Strategies and Future Perspectives

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