HIFU Treatment looks Promising for Localized Prostate Cancer

Data from a large clinical registry showed that over 80 percent of men with localized prostate cancer had negative biopsies for as long as 10 years after treatment with high-intensity focused ultrasound (HIFU).

The negative biopsy rate ranged from 78.3% of patients with high-risk prostate cancer to 89.3% for men with low-risk disease. The 10-year biochemical failure-free survival was 56% by a U.S. definition of biochemical failure and 42% by a German definition.

As reported at the American Urological Association meeting, the most common adverse events were urinary incontinence (mostly grade I) and urethral stenosis (bladder outlet obstruction) occurring in 20.6% and 18.5% of patients, respectively.

HIFU is available throughout Europe but not in the U.S., and it has appealed to many men as a noninvasive therapeutic option for early prostate cancer.  Whole-gland application of high-intensity ultrasound produces thermal and mechanical effects.  HIFU energy rapidly heats tissue to a temperature of greater than 80° C.  The ultrasound also generates gas bubbles that cause cavitation when they collapse, leading to the rupture of cell walls.

Roman Ganzer, MD, of the University of Regensberg in Germany. presented data on 2,552 prostate cancer patients treated with the Ablatherm HIFU system.  The mean age of the study population was 70.1 years.  Eight hundred twenty (32.1%) of patients received short-term hormonal therapy prior to HIFU treatment.  On average, the patients were followed for 3.3 years and as long as 16 years.  Overall, 83% of the patients had negative biopsies at follow-up, including 89.3% of low-risk patients, 81.2% of intermediate-risk patients, and 78.3% of high-risk patients.

In addition to incontinence and urethral stricture, the most common adverse events were infection and urinary retention, both at 11%.

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February 2012
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