1473 TREATMENT FOR RECURRENT LOCALIZED PROSTATE CANCER (PCA) FOLLOWING RADIATION FAILURE WITH HIGH INTENSITY FOCUSED ULTRASOUND (HIFU) RESULTS WITH SONABLATE® 500
Bibliographic record
Abstract
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 ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.022 | 0.008 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".