1473 TREATMENT FOR RECURRENT LOCALIZED PROSTATE CANCER (PCA) FOLLOWING RADIATION FAILURE WITH HIGH INTENSITY FOCUSED ULTRASOUND (HIFU) RESULTS WITH SONABLATE® 500
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Résumé
You have accessJournal of UrologyProstate Cancer: Localized1 Apr 20111473 TREATMENT FOR RECURRENT LOCALIZED PROSTATE CANCER (PCA) FOLLOWING RADIATION FAILURE WITH HIGH INTENSITY FOCUSED ULTRASOUND (HIFU) RESULTS WITH SONABLATE® 500 Ana Maria Autran Gomez, Ali Alzaharani, Jonathan Izawa, and Joseph Chin Ana Maria Autran GomezAna Maria Autran Gomez London, Canada , Ali AlzaharaniAli Alzaharani London, Canada , Jonathan IzawaJonathan Izawa London, Canada , and Joseph ChinJoseph Chin London, Canada View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1408AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Local relapse after External Beam Radiation (EBRT)or Brachtherapy (BT) for localized PCa has been reported in 30–40%. Currently salvage therapy options include radical prostatectomy, brachytherapy and focal ablation with cryotherapy or HIFU. HIFU is a minimally invasive acoustic ablation technique that uses intersecting, precision focused ultrasound waves to raise the temperature of the target tissue to 80–90oC in 2–3 seconds, destroying the prostatic tissue. Few series have reported the efficacy as salvage therapy in terms of oncologic outcomes. The objective is to determinate the ability of HIFU as a salvage therapy in patients with recurrence of localized PCa followed EBRT or BT. METHODS From April 2006 to Sept 2009, 62 patients (pts) (median age 68.0±5.3 years) with histologically confirmed recurrent localized PCa after EBRT or BT,clinical stage T1–T2, PSA level ≤10ng/ml, pre Gleason score ≤8, and no distant metastasis, were subjected to salvage HIFU using Sonablate®500. PSA levels and IPSS, IIEF-5 questionnaires were assessed at 45, 90, 180 days and 12 months. Follow-up biopsy was done at 180 days after HIFU. Biochemical failure was defined according to the Phoenix criteria. Mann- Whitney test was used with p<0.05 statistical significance. RESULTS The pre HIFU parameters were: PSA 4.08±2.96 ng/ml, prostate volume 25.59±9.59 cc. IPSS 7.52±4.81, IIEF-5 9.10±8.42; pre-salvage Gleason ≤6 in 25cases, Gleason 7 in 24 and Gleason 8 in 13. 55(89%) pts had EBRT and 7 had BT. 16 (26%) pts had androgen deprivation pre-HIFU, discontinued post-op. Mean follow-up was 16 months. At follow-up 13(21%) pts presented local relapse at 180 days. Progression-free survival (PFS) rate at 3 years was 60%. With univariable analysis, prostate volume (p=0.010), IPSS (p=0.002), and IIEF-5 (p=0.010) showed statistical difference at 12 months compared with the basal values. Median PSA value was 0.77ng/ml, 0.62ng/ml, 0.80 ng/ml and 0.64ng/ml at 45, 90, 180 and 12 months respectively. Rectourethral fistula occurred in 2(3%) pts, moderate stress urinary incontinence in 2(3%), and urinary retention requiring intervention in 3(5%). There was no difference in complications between EBRT and BT pts. CONCLUSIONS Our results using HIFU (Sonablate®500) showed a low rate of complications with acceptable oncologic results at short- term, being comparable to the reported literature. HIFU is a viable salvage treatment treatment option. A prospective FDA-sponsored multicenter controlled trial is underway to confirm its utility. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e590-e591 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Ana Maria Autran Gomez London, Canada More articles by this author Ali Alzaharani London, Canada More articles by this author Jonathan Izawa London, Canada More articles by this author Joseph Chin London, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,022 | 0,008 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».