Salvage Radiotherapy After High-Intensity Focussed Ultrasound for Recurrent Localised Prostate Cancer

Riviere, Julien; Bernhard, Jean-Christophe; Robert, G.; Wallerand, Hervé; Deti, Edouard; Maurice-Tison, S.; Ardiet, Jean-Michel; Maire, Jean-Philippe; Richaud, Pierre; Ferrière, Jean-Marie; Ballanger, P.; Gelet, A.; Pasticier, G.

doi:10.1016/j.eururo.2010.06.003

Cited by 43 publications

(49 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The largest series for salvage EBRT after HIFU have been reported by Rivière et al [5] and Pasticier et al [6] (the latter an earlier report by the former group), with 100 and 45 patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The best treatment option for these patients is still uncertain, and may include further HIFU treatments, salvage radical prostatectomy or salvage radiation. Salvage external beam radiotherapy (EBRT) after radical prostatectomy has been well documented, however very few reports have assessed the outcomes of EBRT as salvage treatment after HIFU [5,6,7]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Salvage External Beam Radiotherapy for Recurrent Prostate Adenocarcinoma after High-Intensity Focused Ultrasound as Primary Treatment

et al. 2013

View full text Add to dashboard Cite

Introduction: The main objective was to evaluate feasibility, toxicity and biochemical control rates of salvage external beam radiotherapy (EBRT) in recurrent localized prostate cancer after high-intensity focused ultrasound (HIFU) as primary therapy. Patients and Methods: A total of 24 patients who underwent salvage EBRT after 1 or 2 HIFU sessions and with a minimum post-treatment follow-up of 24 months were retrospectively evaluated. Primary endpoints were toxicity and biochemical disease-free survival (bDFS, defined according to the ASTRO Phoenix definition). Results: Median follow-up was 40.3 months. Gastrointestinal toxicity was low. Acute genitourinary (GU) toxicity grade ≤II rate was 45.8%, with only few patients presenting grade III (8.3%) and grade IV (4.2%) toxicity. Late grade ≥III GU toxicity was registered in 16.7% of patients. The 3-year bDFS rate was 77.8%. Patients achieving a nadir prostate-specific antigen (nPSA) of ≤0.35 ng/ml after EBRT had significantly higher bDFS (3-year bDFS: 87.7 vs. 50%, respectively; p = 0.001). Achieving nPSA ≤0.35 ng/ml was the only factor independently associated to long-term bDFS both on univariate (p = 0.01) and multivariate analysis (HR 7.06, p = 0.039). Conclusions: Salvage EBRT after HIFU failure is feasible and allows to obtain satisfactory biochemical control rates, especially in patients attaining a nPSA ≤0.35 ng/ml after EBRT.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Salvage External Beam Radiotherapy for Recurrent Prostate Adenocarcinoma after High-Intensity Focused Ultrasound as Primary Treatment

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Identification of potential residual or recurrent disease is therefore paramount, guiding administration of salvage therapy [5]. Accepted surveillance for residual or recurrent tumour following whole-gland HIFU is reliant on serial prostate-specific antigen (PSA) measurements followed by biopsy for patients with a high or rising PSA [6].…”

mentioning

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

View full text Add to dashboard Cite

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.

show abstract

“…Currently, there are no long-term published data from salvage external-beam series, but there are many reports that show that the combination of radiation and HIFU has a significant impact on erectile function and continence. 20,21 For example, the largest series assessing salvage radiation therapy post-HIFU shows that erectile dysfunction increased from 14% pre-HIFU, to 51.9% post-HIFU, followed by 82.3% post-salvage radiotherapy; this suggests the additive detrimental effects on erectile function. 20 Obviously, further search is required to assess the efficacy and safety in the treatment of HIFU failures, in which a significant number of patients may harbour clinically significant cancers.…”

mentioning

confidence: 99%

“…20,21 For example, the largest series assessing salvage radiation therapy post-HIFU shows that erectile dysfunction increased from 14% pre-HIFU, to 51.9% post-HIFU, followed by 82.3% post-salvage radiotherapy; this suggests the additive detrimental effects on erectile function. 20 Obviously, further search is required to assess the efficacy and safety in the treatment of HIFU failures, in which a significant number of patients may harbour clinically significant cancers. In addition, patients should not receive HIFU assuming that this "non-invasive" treatment can be treated easily with surgery or radiation if the treatment fails.…”

mentioning

confidence: 99%

HIFU ablation is not a proven standard treatment for localized prostate cancer

2011

cuaj

View full text Add to dashboard Cite

Salvage Radiotherapy After High-Intensity Focussed Ultrasound for Recurrent Localised Prostate Cancer

Cited by 43 publications

References 29 publications

Salvage External Beam Radiotherapy for Recurrent Prostate Adenocarcinoma after High-Intensity Focused Ultrasound as Primary Treatment

Salvage External Beam Radiotherapy for Recurrent Prostate Adenocarcinoma after High-Intensity Focused Ultrasound as Primary Treatment

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

HIFU ablation is not a proven standard treatment for localized prostate cancer

Contact Info

Product

Resources

About