The influence of high-energy shock waves on the development of metastases

Oosterhof, G.O.N.; Cornel, Erik B.; Smits, G.A.H.J.; Debruyne, F.M.J.; Schalken, Jack A.

doi:10.1016/0301-5629(95)02051-9

Cited by 79 publications

(55 citation statements)

References 28 publications

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“…HIFU acts through coagulative necrosis of the tissue to destroy prostate cells without damaging the intervening structures [22,23]. It can be used as primary therapy with effective long-term cancer control in patients with low-or intermediate-risk localized CaP [10].…”

Section: Discussionmentioning

confidence: 99%

HIFU as salvage first-line treatment for palpable, TRUS-evidenced, biopsy-proven locally recurrent prostate cancer after radical prostatectomy: A pilot study

Asimakopoulos

Miano

Virgili

et al. 2012

Urologic Oncology: Seminars and Original Investigations

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Objective: To test high-intensity focused ultrasound (HIFU) as salvage first-line treatment for palpable, TRUS-evidenced, biopsyproven locally recurrent prostate cancer (CaP) after radical prostatectomy (RP). Materials and methods:Nineteen patients with palpable, TRUS-evidenced, biopsy-proven local recurrence of CaP after RP, unwilling to undergo salvage radiotherapy (SRT), underwent HIFU as a single-session procedure. Pre-, intra-, and postoperative data including early and late complications, and oncologic outcomes (PSA nadir, biochemical recurrence (BCR)-free survival, and need of secondary adjuvant treatment) were prospectively evaluated. Success was defined as PSA nadir Յ0.1 ng/ml obtained within 3 months from HIFU. In case of PSA nadir Ͼ0.1 ng/ml or PSA increase Ն1 ng/ml above the PSA nadir, a biopsy of the treated lesion was performed, and if negative, maximum androgen blockade (MAB) was adopted. In case of positive biopsy, RT was performed. Failure was defined as use of secondary adjuvant treatment (MAB or RT).Results: Median follow-up was 48 months. All cases were performed as overnight procedure. No case of urethrorectal fistula or anastomotic stricture was observed. Two cases of acute urinary retention were resolved with prolonged urethral catheterization. Four cases of stress urinary incontinence were observed; 2 (mild incontinence) were resolved after pelvic floor exercises within 6 months, while 2 cases of severe incontinence required surgical minimally invasive treatment;17/19 patients (89,5%) were classified as success. Two patients failed to show a PSA nadir Ͻ0.1 ng/ml. During follow-up, 8/17 patients (47%) were classified as failure, with consequent total rate of failures 10/19 (52.6%). A statistically significant difference was observed in pre-HIFU median PSA (2 vs. 5.45 ng/ml, respectively, P ϭ 0.013) and Gleason score of the RP specimen (P ϭ 0.01) between the success and failure group.Conclusions: Salvage first-line HIFU for palpable, TRUS-evidenced, biopsy-proven local recurrence of CaP is a feasible, minimally invasive day-case procedure, with an acceptable morbidity profile. It seems to have a good cancer control in the short-and mid-term. Patients with lower pre-HIFU PSA level and favorable pathologic Gleason score presented better oncologic outcomes. A prospective randomized trial with an adequate recruitment and follow-up is necessary to confirm our preliminary oncologic results.

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Section: Discussionmentioning

confidence: 99%

HIFU as salvage first-line treatment for palpable, TRUS-evidenced, biopsy-proven locally recurrent prostate cancer after radical prostatectomy: A pilot study

Asimakopoulos

Miano

Virgili

et al. 2012

Urologic Oncology: Seminars and Original Investigations

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“…According to the size and shape of tumor, it determines therapy range of tumor target zone, overlays tumor target zone. Therefore, treatment of malignant tumor using HIFU has many advantages such as less pain, no damage, fewer influences on splanchnic function, faster recovery for body and no increase of tumor metastasis chance [20] , etc. It is shown that in this research, 100 liver cancer patients had obvious improvement in symptoms and signs after being treated by using HIFU.…”

Section: Discussionmentioning

confidence: 99%

Analysis of clinical effect of high-intensity focused ultrasound on liver cancer

Li¹,

Xu²,

Jiang³

et al. 2004

WJG

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AIM:To evaluate the clinical effect of high-intensity focused ultrasound (HIFU) in the treatment of patients with liver cancer.METHODS: HIFU treatment was performed in 100 patients with liver cancer under general anesthesia and by a targeted ultrasound. Evaluation of efficacy was made on the basis of clinical symptoms, liver function tests, AFP, MRI or CT before and after the treatment. RESULTS:After HIFU treatment, clinical symptoms were relieved in 86.6%(71/82) of patients. The ascites disappeared in 6 patients. ALT (95±44) U/L and AST (114±58) U/L before HIFU treatment were reduced to normal in 83.3%(30/36) and 72.9%(35/48) patients, respectively, after the treatment. AFP was lowered by more than 50% in 65.3%(32/49) patients. After HIFU treatment, MRI or CT findings indicated coagulation necrosis and blood supply reduction or disappearance of tumor in the target region.CONCLUSION: HIFU can efficiently treat the patients with liver cancer. It will offer a significant noninvasive therapy for local treatment of liver tumor.

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“…Another concern is that HIFU may promote the spread of metastases. Small animal studies have shown that HIFU does not increase the risk of metastatic spread (Oosterhof et al, 1997), and there is evidence that ablative therapies may upregulate the response of host immune system to subsequent tumour challenge (Yang et al, 1992;den Brok et al, 2004).…”

Section: Kidneymentioning

confidence: 99%

The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumours in a Western population

et al. 2005

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High-intensity focused ultrasound (HIFU) provides a potential noninvasive alternative to conventional therapies. We report our preliminary experience from clinical trials designed to evaluate the safety and feasibility of a novel, extracorporeal HIFU device for the treatment of liver and kidney tumours in a Western population. The extracorporeal, ultrasound-guided Model-JC Tumor Therapy System (HAIFUt Technology Company, China) has been used to treat 30 patients according to four trial protocols. Patients with hepatic or renal tumours underwent a single therapeutic HIFU session under general anaesthesia. Magnetic resonance imaging 12 days after treatment provided assessment of response. The patients were subdivided into those followed up with further imaging alone or those undergoing surgical resection of their tumours, which enabled both radiological and histological assessment. HIFU exposure resulted in discrete zones of ablation in 25 of 27 evaluable patients (93%). Ablation of liver tumours was achieved more consistently than for kidney tumours (100 vs 67%, assessed radiologically). The adverse event profile was favourable when compared to more invasive techniques. HIFU treatment of liver and kidney tumours in a Western population is both safe and feasible. These findings have significant implications for future noninvasive image-guided tumour ablation.

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The influence of high-energy shock waves on the development of metastases

Cited by 79 publications

References 28 publications

HIFU as salvage first-line treatment for palpable, TRUS-evidenced, biopsy-proven locally recurrent prostate cancer after radical prostatectomy: A pilot study

HIFU as salvage first-line treatment for palpable, TRUS-evidenced, biopsy-proven locally recurrent prostate cancer after radical prostatectomy: A pilot study

Analysis of clinical effect of high-intensity focused ultrasound on liver cancer

The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumours in a Western population

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