MP18-06 SALVAGE EXTERNAL BEAM RADIATION THERAPY (EBRT) FOR LOCAL RECURRENCE AFTER HIGH INTENSITY FOCUSED ULTRASOUND (HIFU) FAILURE VERSUS SALVAGE HIFU FOR LOCAL RECURRENCE AFTER EBRT FAILURE: A MATCHED PAIR COMPARISON

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy1 Apr 2016MP18-06 SALVAGE EXTERNAL BEAM RADIATION THERAPY (EBRT) FOR LOCAL RECURRENCE AFTER HIGH INTENSITY FOCUSED ULTRASOUND (HIFU) FAILURE VERSUS SALVAGE HIFU FOR LOCAL RECURRENCE AFTER EBRT FAILURE: A MATCHED PAIR COMPARISON Ji-Wann Lee, Albert Gelet, Jeremy Soria, Marc Colombel, Pascal Pommier, Christelle Melodelima, Olivier Rouviere, Lionel Badet, and Sebastien Crouzet Ji-Wann LeeJi-Wann Lee More articles by this author , Albert GeletAlbert Gelet More articles by this author , Jeremy SoriaJeremy Soria More articles by this author , Marc ColombelMarc Colombel More articles by this author , Pascal PommierPascal Pommier More articles by this author , Christelle MelodelimaChristelle Melodelima More articles by this author , Olivier RouviereOlivier Rouviere More articles by this author , Lionel BadetLionel Badet More articles by this author , and Sebastien CrouzetSebastien Crouzet More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2707AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES EBRT is one of the gold standard treatments for localized prostate cancer. High Intensity Focused Ultrasound (HIFU) is a new minimally invasive treatment option with promising outcomes. HIFU is one of salvage option after EBRT failure and EBRT is the standard salvage option for local relapse after HIFU. No randomized study is available to compare these two strategies of salvage treatment after a first line therapy. The goal was to evaluate the oncologic outcomes by using a matched pair analysis to compare patients treated with HIFU first + salvage EBRT (S-EBRT) versus EBRT first + salvage HIFU (S-HIFU) METHODS This retrospective study was designed to overcome limitations of case series studies by using a matched pair design in patients treated contemporaneously with salvage HIFU and salvage EBRT in the same institution between 1994 and 2014. Cancer specific free survival rate were the primary endpoints. Secondary endpoints were metastasis free survival rate, and survival rate without salvage androgen deprivation therapy (S-ADT). The progression free survival rates were calculated with Kaplan-Meier estimate RESULTS A total of 480 patients received S-HIFU for EBRT failure and 370 received S-EBRT for HIFU failure. Those 850 patients were prospectively followed and matched to a 1:1 basis following known prognostic variables: PSA level, Gleason score and d’Amico risk classification. A perfect match was obtained for 342 patients (171 in each group). The mean age was significantly lower in the EBRT: 65.26±5.87 years versus 68.82±5.41 years (p:<0.001). In the EBRT first group the mean dose was 71.02±3.74 Grays. The delay between EBRT and salvage HIFU was 5.07±2.4 months. The mean PSA value before salvage HIFU was 4.73±3.68ng/ml and the Gleason score of the recurrence was =6 in 36.16% of patients, 7 in 30.99 % and =8 in in 32.75 %. In the HIFU first group the mean number of HIFU sessions was 1.58±053 per patient, the mean delay between HIFU and S-EBRT was 3.11±2.35 months, the mean PSA value before S-EBRT was 3.03±2.84 ng and the Gleason score of the recurrence was =6 in 60.23% of patients, 7 in 27.49% and =8 in 12.28%. The cancer specific free survival rate at 60 and 120 months was significantly better (log rank test, p:0.035) after HIFU+S-EBRT than after EBRT+S-HIFU (99.4% and 94.8% versus 93.1% and 83.7% respectively). The metastatic free survival rate at 60 and 120 months was significantly better (log rank test, p< 0.001) after HIFU+S-EBRT than after EBRT+S-HIFU (95.3% and 85% versus 85.2 % and 69.4% respectively). The palliative androgen deprivation free rate at 60 months was also significantly different (Log rank test, p<0.001) after HIFU+S-EBRT than after EBRT+S-HIFU (84.7% versus 40.7%). However, the delay between the first treatment and the salvage therapy was longer in the EBRT+S-HIFU group CONCLUSIONS In our department, the cancer specific survival rate, the metastatic free survival rate and the palliative androgen deprivation free rate was significantly better in the HIFU+S-EBRT group than in the EBRT+S-HIFU group in a matched pair comparison © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e194 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Ji-Wann Lee More articles by this author Albert Gelet More articles by this author Jeremy Soria More articles by this author Marc Colombel More articles by this author Pascal Pommier More articles by this author Christelle Melodelima More articles by this author Olivier Rouviere More articles by this author Lionel Badet More articles by this author Sebastien Crouzet More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...