Prostate cancer treatment with Irreversible Electroporation (IRE): Safety, efficacy and clinical experience in 471 treatments.

BackgroundIrreversible Electroporation (IRE) is a novel image-guided tissue ablation technology that induces cell death via very short but strong pulsed electric fields. IRE has been shown to have preserving properties towards vessels and nerves and the extracellular matrix. This makes IRE an ideal candidate to treat prostate cancer (PCa) where other treatment modalities frequently unselectively destroy surrounding structures inducing severe side effects like incontinence or impotence. We report the retrospective assessment of 471 IRE treatments in 429 patients of all grades and stages of PCa with 6-year maximum follow-up time.Material and findingsThe patient cohort consisted of low (25), intermediate (88) and high-risk cancers (312). All had multi-parametric magnetic resonance imaging, and 199 men had additional 3D-mapping biopsy for diagnostic work-up prior to IRE. Patients were treated either focally (123), sub-whole-gland (154), whole-gland (134) or for recurrent disease (63) after previous radical prostatectomy, radiation therapy, etc. Adverse effects were mild (19.7%), moderate (3.7%) and severe (1.4%), never life-threatening. Urinary continence was preserved in all cases. IRE-induced erectile dysfunction persisted in 3% of the evaluated cases 12 months post treatment. Mean transient IIEF-5-Score reduction was 33% within 12-month post IRE follow-up and 15% after 12 months. Recurrences within the follow-up period occurred in 10% of the treated men, 23 in or adjacent to the treatment field and 18 outside the treatment field (residuals). Including residuals for worst case analysis, Kaplan Maier estimation on recurrence rate at 5 years resulted in 5.6% (CI95: 1.8-16.93) for Gleason 6, 14.6% (CI95: 8.8-23.7) for Gleason 7 and 39.5% (CI95: 23.5-61.4) for Gleason 8-10.ConclusionThe results indicate comparable efficacy of IRE to standard radical prostatectomy in terms of 5-year recurrence rates and better preservation of urogenital function, proving the safety and suitability of IRE for PCa treatment. The data also shows that IRE, besides focal therapy of early PCa, can also be used for whole-gland ablations, in patients with recurrent PCa, and as a problem-solver for local tumor control in T4-cancers not amenable to surgery and radiation therapy anymore

Field-Dependent Hall Effect in Single Crystal Heavy Fermion YbAgGe below 1K

We report the results of a low temperature (T >= 50 mK) and high field (H <= 180 kOe) study of the Hall resistivity in single crystals of YbAgGe, a heavy fermion compound that demonstrates field-induced non-Fermi-liquid behavior near its field-induced quantum critical point. Distinct features in the anisotropic, field-dependent Hall resistivity sharpen on cooling down and at the base temperature are close to the respective critical fields for the field-induced quantum critical point. The field range of the non-Fermi-liquid region decreases on cooling but remains finite at the base temperature with no indication of its conversion to a point for T -> 0. At the base temperature, the functional form of the field-dependent Hall coefficient is field direction dependent and complex beyond existing simple models thus reflecting the multi-component Fermi surface of the material and its non-trivial modification at the quantum critical point

Magnetically-induced electric polarization in an organo-metallic magnet

The coupling between magnetic order and ferroelectricity has been under intense investigation in a wide range of transition-metal oxides. The strongest coupling is obtained in so-called magnetically-induced multiferroics where ferroelectricity arises directly from magnetic order that breaks inversion symmetry. However, it has been difficult to find non-oxide based materials in which these effects occur. Here we present a study of copper dimethyl sulfoxide dichloride (CDC), an organo-metallic quantum magnet containing $S = 1/2$ Cu spins, in which electric polarization arises from non-collinear magnetic order. We show that the electric polarization can be switched in a stunning hysteretic fashion. Because the magnetic order in CDC is mediated by large organic molecules, our study shows that magnetoelectric interactions can exist in this important class of materials, opening the road to designing magnetoelectrics and multiferroics using large molecules as building blocks. Further, we demonstrate that CDC undergoes a magnetoelectric quantum phase transition where both ferroelectric and magnetic order emerge simultaneously as a function of magnetic field at very low temperatures

Spin-strain coupling in NiCl2-4SC(NH2)2

We report results of ultrasonic investigations of the quantum S = 1 spin-chain magnet NiCl2-4SC(NH2)2, also known as DTN, in magnetic fields up to 18 T and temperatures down to 0.3 K. A field H along the [001] direction induces a transition into an antiferromagnetic phase with T(N)max ≈ 1.2 K. Accordingly, at T = 0 there are two quantum critical points at ~2.1 T and at ~12.6 T. The acoustic c33 mode, propagating along the spin chains, shows a pronounced softening close to the phase transition, accompanied by energy dissipation of the sound wave. The H-T phase diagram obtained from our measurements is compared with results from other experimental investigations and the low-temperature acoustic anomalies are traced up to T > T(N). We also report frequency-dependent effects, which open the possibility to investigate the spin fluctuations in the critical regions. Our observations show an important role of the spin-phonon coupling in DTN

Magnetoelectric effects in an organo-metallic quantum magnet

We observe a bilinear magnetic field-induced electric polarization of 50 $\mu C/m^2$ in single crystals of NiCl$_2$-4SC(NH$_2$)$_2$ (DTN). DTN forms a tetragonal structure that breaks inversion symmetry, with the highly polar thiourea molecules all tilted in the same direction along the c-axis. Application of a magnetic field between 2 and 12 T induces canted antiferromagnetism of the Ni spins and the resulting magnetization closely tracks the electric polarization. We speculate that the Ni magnetic forces acting on the soft organic lattice can create significant distortions and modify the angles of the thiourea molecules, thereby creating a magnetoelectric effect. This is an example of how magnetoelectric effects can be constructed in organo-metallic single crystals by combining magnetic ions with electrically polar organic elements.Comment: 3 pages, 3 figure