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High intensity focused ultrasound effective for localized prostate cancer

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Patients with localized prostate cancer can be treated successfully with high-intensity focused ultrasound (HIFU), with results comparable to those expected with external-beam radiation therapy, a French group reports,

The authors explain in an online issue of European Urology published July 3 that HIFU treatment of the prostate works by focusing high-powered ultrasound energy, generated by a spherical transducer placed in the rectum, to produce temperatures of 85 C at the focal point. Transurethral resection of the prostate (TURP) is performed prior to HIFU treatment.

For the current study, patients were selected on the basis of clinical stage (T1-T2, N0, M0), no previous prostatectomy or radiation treatment, and no neoadjuvant hormone therapy.

Dr. Sebastien Crouzet at the Universite´ de Lyon, France, and colleagues analyzed data on 803 eligible patients after a mean follow-up of 42 months.

A mean PSA nadir of 1.0 ng/mL was reached in a mean time of 12.9 weeks after HIFU therapy. Prostate size dropped from a mean of 24.5 mL immediately after the TURP procedure, to 13.6 mL after HIFU.

Control biopsies were negative in 77.9% of patients, the team reports. “The overall and cancer-specific survival rates (CSSR) at 8 years were 89% and 99%, respectively.” The 8-year metastasis-free survival rate was 97%.

“HIFU can be repeated when necessary several months or several years after the first session and can also be followed by a salvage radiation therapy,” the investigators write. “This probably explains the excellent middle-term CSSR achieved in this multicenter study despite the presence of intermediate- and high-risk patients.”


Multicentric Oncologic Outcomes of High-Intensity Focused Ultrasound for Localized Prostate Cancer in 803 Patients

Eur Urol 2010.