Table 2.
Target population with stage of evaluation and level of evidence of the five studies using focal therapy in the primary setting
| Eligibility criteria |
|||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Reference | Setting | IDEAL stage of evaluation | Previous treatment, no. (%) | Patients, no. | Age, yr | Preoperative biopsy | Preoperative imaging | Criteria for bDFS | Spatial location | PSA level, ng/ml |
Gleason score | Risk classification (D’Amico or NCCN) | Level of evidence |
| Shariat et al. [40] | Salvage (n = 8) Primary (n = 3) |
1 | EBRT: 8 (73) | 11 | Median: 77 (range: 60–82) | TRUS 12-core biopsy | NR | NR | NR | NR | NR | NR | 2c |
| Nguyen et al. [41] | Salvage | 2a | EBRT: 12 (48) Brachytherapy: 12 (48) Brachytherapy plus EBRT: 1 (4) |
25 | Median: 65 (range: 56–82) | TRUS biopsy | CT or MRI Bone scan |
Phoenix | NR | <10 | ≤4 + 3 | NR | 2b |
| Eisenberg et al. [42] | Salvage | 2a | EBRT with some men (n = NR) receiving permanent seed implantation and/or ADT: 18 (100) | 18 | Mean: 70.6 (range: 58–86) | TRUS 16-core biopsy | CT Bone scan |
ASTRO and Phoenix | Unilateral | NR | NR | NR | 4 |
| Ahmed et al. [43] | Salvage | 2b | EBRT: 39 (100) Short-term ADT (stopped at treatment): 13 (33) |
39 | Mean: 70.5 (SD: 6.8) | Transperineal template biopsy (n = 20) or TRUS biopsy (n = 19) | MRI FDG-PET |
Phoenix and Stuttgart | NR | NR | NR | NR | 4 |
| Abreu et al. [44] | Salvage | 2b | EBRT: 11 (44) Proton beam radiotherapy: 8 (32) Brachytheraphy: 5 (20) Brachytheraphy plus EBRT: 1 (4) Short-term ADT (stopped at treatment): 9 (36) |
25 | Median: 71 (range: 59–81) | TRUS sextant biopsy plus mapping target biopsy of suspicious areas | TRUS Doppler | Phoenix | Unilateral | ≤20 | No restriction | No restriction | 3b |
bDFS = biochemical disease-free survival; PSA = prostate-specific antigen; NCCN = National Comprehensive Cancer Network; EBRT = external beam radiation therapy; TRUS = transrectal ultrasound; NR = not reported; CT = computed tomography; MRI = magnetic resonance imaging; ADT = androgen-deprivation therapy; ASTRO = American Society for Therapeutic Radiology and Oncology; FDG-PET = 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography.