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Focal treatment for prostate cancer has been proposed as an innovative strategy that aims to achieve oncological benefit while reducing treatment-related morbidity. This treatment is suitable for patients with low and intermediate risk, organ-confined disease. Focal therapy can be categorized as follows: unifocal index lesion ablation, multifocal ablation, hemi-gland ablation or subtotal gland ablation. Different types of energies are applied in focal therapy including high intensity focal ultrasound (HIFU), cryotherapy, focal laser ablation (FLA), irreversible electroporation (IRE) and Photodynamic therapy (PDT). In this review we will briefly present a summary of leading techniques and the available data regarding their oncological outcomes and adverse events. Whole-gland therapies were excluded from this review.
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Adv Radiat Oncol
October 2025
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiation Oncology and Radiotherapy, Augustenburger Platz 1, 13353 Berlin, Germany.
Purpose: To evaluate the impact of an optimized online adaptive radiation therapy workflow on physician involvement.
Methods And Materials: Data from a prospective phase 2 trial involving 34 prostate cancer patients treated with cone beam computed tomography (CBCT)-based online adaptive radiation therapy (62 Gy in 20 fractions) were analyzed. Manual interventions were required for 2 steps in the workflow: radiation therapy technologist review and adjustment of automatically segmented organs, guiding target segmentation, so-called "influencer," while physicians reviewed and refined the targets.
BJUI Compass
September 2025
Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine Kyoto University Kyoto Kyoto Japan.
Objectives: To develop a novel risk score (RS) model to predict the probability of progression to castration-resistant prostate cancer (PCa) (CRPC) after intensity-modulated radiation therapy (IMRT) for patients with high- and very high-risk PCa according to the National Comprehensive Cancer Network (NCCN) risk classification, since accurate prediction of the clinical outcome of definitive radiation therapy for patients with high- and very high-risk PCa remains challenging due to its heterogeneity.
Materials And Methods: We conducted a retrospective review of 600 patients with high- and very high-risk PCa treated with IMRT at our institution. They were randomly divided into discovery (n = 300) and validation (n = 300) cohorts.
Med Phys
September 2025
Department of Radiation Oncology, Mayo Clinic in Florida, Jacksonville, Florida, USA.
Background: Dose-driven continuous scanning (DDCS) enhances the efficiency and precision of proton pencil beam delivery by reducing beam pauses inherent in discrete spot scanning (DSS). However, current DDCS optimization studies using traveling salesman problem (TSP) formulations often rely on fixed beam intensity and computationally expensive interpolation for move spot generation, limiting efficiency and methodological robustness.
Purpose: This study introduces a Break Spot-Guided (BSG) method, combined with two acceleration strategies-dose rate skipping and bounding-to optimize beam intensity while minimizing beam delivery time (BDT).
Prostate
September 2025
Department of Urology, University of Rochester Medical Center, Rochester, New York, USA.
Background: Prostate cancer (PCa) is the only cancer in men to exhibit androgen sensitivity at diagnosis, which has allowed for the development of androgen deprivation therapy (ADT). However, outcomes in high-risk PCa (HRPCa) remain significantly worse than low risk disease and the use of ADT varies among treatment algorithms and medical specialties. In men treated with radiation, testosterone recovery after completing ADT has been associated with oncologic outcomes.
View Article and Find Full Text PDFCancer Med
September 2025
Hospital Vírgen del Puerto, Extremadura, Spain.
Patients And Methods: In this multicenter longitudinal study, data from the Spanish Register in AS (AEU-PIEM/2014/0001) were reviewed. The study focused on a cohort of AS patients registered between 2014 and 2019, featuring open inclusion criteria and diverse follow-up strategies.
Results: A total of 3315 AS patients were recruited, with 2881 and 434 categorized into the low and intermediate risk groups based on NCCN grouping at inclusion.