The FUTURE trial; a multicenter RCT on three techniques of MRI targeted prostate biopsy

Wegelin, O.; Exterkate, Leonie; Somford, Diederik M.; Barentsz, J.; Leest,; Der, M. Van; Kümmer, Alain; Vreuls, Willem; Bruin,; De, Pongratz; Bosch, Ruud; Melick,; van, Heugten C.M.

doi:10.1016/s1569-9056(18)31321-6

Cited by 2 publications

(1 citation statement)

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“…Adding mp-MRI information to subsequent TPM biopsies seems to achieve the highest diagnostic accuracy, with a sensitivity and specificity of 97% and 61%, respectively, a positive predictive value of 83%, and a negative predictive value of 91% [64]. Different approaches to achieve biopsy under MRI-guidance (i.e., in-bore, MRI/TRUS fusion, or cognitive registration) yield similar detection rates of clinically significant prostate cancer [65]. Interestingly, the definition of clinically significant cancer differs between studies, ranging from Gleason score 6 and cancer core length >3 mm to Gleason score ≥ 4 + 3.…”

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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Section: Focal Treatment Of Radiorecurrent Prostate Cancermentioning

confidence: 99%