Baumunk, Daniel and Cash, H. and Ebbing, J. and Porsch, M. and Janitzky, A. and Wendler, J. J. and Liehr, U. -B. and Ganzer, R. and Blana, A. and Schostak, M. (2012) HIFU in Salvage Treatment of Patients with Prostate Cancer after Primary External Radiation Therapy - Status 2012. AKTUELLE UROLOGIE, 43 (5). pp. 330-336. ISSN 0001-7868,
Full text not available from this repository. (Request a copy)Abstract
Background: Patients with (local) recurrence of prostate cancer after radiation therapy face the question of the appropriate diagnostic and possible therapeutic options. Many patients in this setting receive palliative androgen deprivation therapy alone, with arguable impact on overall cancer survival. In the case of an isolated local recurrence, salvage prostatectomy represents a potentially curative therapeutic option, albeit with a high complication rate. Alternatively, these patients can be offered a local treatment with salvage HIFU therapy. Material and Methods: Salvage HIFU therapy is based on the thermal ablation of tissue through high-intensity focused ultrasound. In addition, the formation of microbubbles (cavitation) and their implosion lead to an enhancement of tissue ablation. Results: The results of 6 monocentric studies (2004-2011) with an overall number of 408 patients (22-167 patients) are presented and critically reviewed. The median follow-up was 18.71 months (7.4-39). The 3-year progression free survival (PFS) varied from 25% (D'Amico high risk) to 53% (D'Amico low-risk), the 5-year overall survival was 90%. The rate of urinary incontinence varied between 7 and 60% in all grades (grade III urinary incontinence 0-9.5%). In 22 cases surgical incontinence treatment was performed. 53 patients developed a urethral stricture or stenosis leading to surgical treatment. Urethral-rectal fistulae were seen in 0-7%. Conclusions: The current data on salvage HIFU can be evaluated as insufficient. The main criticisms can be seen in the lack of randomization, the monocentric and retrospective analyses of the data, the heterogeneous stratification of risk groups as well as inadequate definition of postinterventional treatment failure. The studies indicate that salvage HIFU therapy leads to a mid-term overall survival with complication rates that are comparable to those of other local salvage therapies. Randomized multi-centric studies are needed to further validate the results of salvage HIFU therapy.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INTENSITY FOCUSED ULTRASOUND; BEAM RADIOTHERAPY; FAILURE; ULTRASONOGRAPHY; EXPERIENCE; prostate cancer; recurrence after radiation therapy; salvage HIFU therapy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 May 2020 06:55 |
| Last Modified: | 06 May 2020 06:55 |
| URI: | https://pred.uni-regensburg.de/id/eprint/18142 |
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