THIS IS AN UPDATE IN THE LATEST TECHNOLOGY AVAILABLE FOR DIFFERENT ILLNESSES
Tuesday, September 22, 2009
Found Dr. Suarez
Dear Harold, I am sending you the web site that Dr. Suarez has. Please let me know how it goes when you speak to him. Regards, Edith Ramseywww.hifumedicalexpert.com
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Anonymous
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Two of several studies presented at the AUA annual meeting by the same international team suggest that high-intensity focused ultrasound (HIFU) provides good biochemical-free survival (BFS) at 5 years in pa-tients treated in the absence of hormone therapy. Data from the study also indicate that criteria unique to the technology are more reliable for predicting outcomes than criteria established for other procedures, such as radiation therapy.
Study co-author John F. Ward, MD, assistant professor of urology at the M.D. Anderson Cancer Center, Houston, said that the two studies were conducted to establish criteria that would allow accurate evaluation of HIFU outcomes. The technology is not approved in the United States, but its use is growing in Canada, the United Kingdom, and several countries in Europe and Asia.
The first of the two studies looked at men treated for prostate cancer using HIFU, but without previous hormone therapy.
"We wanted to a-void the confusion that androgen ablation therapy causes when you are looking at PSA outcomes," Dr. Ward told Urology Times. "This is especially problematic in older men, who often will take several months to a few years to recover their testosterone levels following surgery. It makes the use of PSA levels difficult to interpret."
The researchers used data from the Ablatherm Treatment Registry (also known as the "@-Registry") to identify 468 patients who met the study's inclusion criteria: localized disease (T1-2), no interventions for prostate cancer other than HIFU, and treatment with curative intent with a minimum of 2-year follow-up. The patients were stratified according to D'Amico risk categories.
The median pre-treatment PSA was 6.9 ± 25.8 months. The median PSA nadir following treatment was 0.1 ng/mL and was reached 16 ± 12.3 weeks following the procedure.
88% achieve BFS at 5 years
The BFS rates for the patients were evaluated according to two risk measures. The first was the Phoenix definition of biochemical failure (nadir + 2.0 ng/mL PSA rise). The second was the Stuttgart definition of biochemical failure (nadir +1.2 ng/mL PSA rise). This latter definition was designed specifically to evaluate patients receiving HIFU.
Under the Phoenix definition, 86% of the low-risk and 88% of moderate-risk patients achieved BFS at 5 years. Under the Stuttgart definition, 79% of the low-risk and 71% of moderate-risk patients achieved BFS at 5 years. There were too few high-risk patients to allow for reliable evaluation.
"HIFU appears to have intermediate outcomes comparable to other treatment modalities for low- and moderate-risk patients, but this will have to be studied at a longer follow-up," said Dr. Ward. He added that PSA measures should not be the sole factors for determining interventions such as salvage therapy; PSA kinetics, biopsy results, co-morbidities, age, and clinical experience should be considered as well.
1 comment:
Two of several studies presented at the AUA annual meeting by the same international team suggest that high-intensity focused ultrasound (HIFU) provides good biochemical-free survival (BFS) at 5 years in pa-tients treated in the absence of hormone therapy. Data from the study also indicate that criteria unique to the technology are more reliable for predicting outcomes than criteria established for other procedures, such as radiation therapy.
Study co-author John F. Ward, MD, assistant professor of urology at the M.D. Anderson Cancer Center, Houston, said that the two studies were conducted to establish criteria that would allow accurate evaluation of HIFU outcomes. The technology is not approved in the United States, but its use is growing in Canada, the United Kingdom, and several countries in Europe and Asia.
The first of the two studies looked at men treated for prostate cancer using HIFU, but without previous hormone therapy.
"We wanted to a-void the confusion that androgen ablation therapy causes when you are looking at PSA outcomes," Dr. Ward told Urology Times. "This is especially problematic in older men, who often will take several months to a few years to recover their testosterone levels following surgery. It makes the use of PSA levels difficult to interpret."
The researchers used data from the Ablatherm Treatment Registry (also known as the "@-Registry") to identify 468 patients who met the study's inclusion criteria: localized disease (T1-2), no interventions for prostate cancer other than HIFU, and treatment with curative intent with a minimum of 2-year follow-up. The patients were stratified according to D'Amico risk categories.
The median pre-treatment PSA was 6.9 ± 25.8 months. The median PSA nadir following treatment was 0.1 ng/mL and was reached 16 ± 12.3 weeks following the procedure.
88% achieve BFS at 5 years
The BFS rates for the patients were evaluated according to two risk measures. The first was the Phoenix definition of biochemical failure (nadir + 2.0 ng/mL PSA rise). The second was the Stuttgart definition of biochemical failure (nadir +1.2 ng/mL PSA rise). This latter definition was designed specifically to evaluate patients receiving HIFU.
Under the Phoenix definition, 86% of the low-risk and 88% of moderate-risk patients achieved BFS at 5 years. Under the Stuttgart definition, 79% of the low-risk and 71% of moderate-risk patients achieved BFS at 5 years. There were too few high-risk patients to allow for reliable evaluation.
"HIFU appears to have intermediate outcomes comparable to other treatment modalities for low- and moderate-risk patients, but this will have to be studied at a longer follow-up," said Dr. Ward. He added that PSA measures should not be the sole factors for determining interventions such as salvage therapy; PSA kinetics, biopsy results, co-morbidities, age, and clinical experience should be considered as well.
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