Transrectal high-intensity focused ultrasound for treatment of patients with stage T1b-2n0m0 localized prostate cancer: a preliminary report

Uchida, Τοyoaki; Sanghvi, Narendra T.; Gardner, Thomas A.; Koch, Michaël; Ishii, Daisuke; Minei, Sadanori; Satoh, Takefumi; Hyodo, Toru; Irie, Akira; Baba, Shirō

doi:10.1016/s0090-4295(01)01624-7

Cited by 187 publications

(159 citation statements)

References 23 publications

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“…Since then, many studies have confirmed the efficacy and safety of HIFU in the treatment of early localized PCa. 17,18 However, clinical results have shown a substantially increased ratio of biochemical recurrence and positive biopsy among the patients with high-risk or locally advanced PCa who underwent HIFU therapy. 19,20 This may have resulted from the following factors: (i) the ultrasound positioning system could not accurately demarcate the invasive margin of advanced PCa, which led to the insufficiency of treatment; and (ii) patients with high-risk or locally advanced PCa had a high risk of pelvic lymph node involvement due to the blind zone beyond target areas of HIFU treatment.…”

Section: Discussionmentioning

confidence: 99%

The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

Wu¹,

Wang²,

Xu³

et al. 2011

Asian J Androl

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The aim of this study was to investigate the feasibility and safety of high-intensity focused ultrasound (HIFU) combined with (1) low-dose external beam radiotherapy (LRT) as supplemental therapy for advanced prostate cancer (PCa) following hormonal therapy (HT). Our definition of HIFU1LRT refers to treating primary tumour lesions with HIFU in place of reduced field boost irradiation to the prostate, while retaining four-field box irradiation to the pelvis in conventional-dose external beam radiotherapy (CRT). We performed a prospective, controlled and non-randomized study on 120 patients with advanced PCa after HT who received HIFU, CRT, HIFU1LRT and HT alone, respectively. CT/MR imaging showed the primary tumours and pelvic lymph node metastases visibly shrank or even disappeared after HIFU1LRT treatment. There were significant differences among four groups with regard to overall survival (OS) and disease-specific survival (DSS) curves (P50.018 and 0.015). Further comparison between each pair of groups suggested that the long-term DSS of the HIFU1LRT group was higher than those of the other three groups, but there was no significant difference between the HIFU1LRT group and the CRT group. Multivariable Cox's proportional hazard model showed that both HIFU1LRT and CRT were independently associated with DSS (P50.001 and 0.035) and had protective effects with regard to the risk of death. Compared with CRT, HIFU1LRT significantly decreased incidences of radiation-related late gastrointestinal (GI) and genitourinary (GU) toxicity grade oII. In conclusion, long-term survival of patients with advanced PCa benefited from strengthening local control of primary tumour and regional lymph node metastases after HT. As an alternative to CRT, HIFU1LRT showed good efficacy and better safety.

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Section: Discussionmentioning

confidence: 99%

The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

Wu¹,

Wang²,

Xu³

et al. 2011

Asian J Androl

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show abstract

“…In clinical applications, real-time imaging modalities including both US (Vallancien et al, 1996;Beerlage et al, 1999;Chapelon et al, 1999;Gelet et al, 1999;Wu et al, 2001aWu et al, , 2002Uchida et al, 2002) and MRI Hynynen et al, 2001) can guide HIFU ablation of solid tumours. These imaging techniques have been used for targeting the lesion to be treated, monitoring the therapeutic procedure, assessing the thermal effects on target tissue, and controlling the ultrasonic energy.…”

Section: Discussionmentioning

confidence: 99%

A randomised clinical trial of high-intensity focused ultrasound ablation for the treatment of patients with localised breast cancer

et al. 2003

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High-intensity focused ultrasound (HIFU) is a noninvasive treatment that induces complete coagulative necrosis of a tumour at depth through the intact skin. This study was to explore the possibility of using HIFU for the treatment of patients with localised breast cancer in a controlled clinical trial. A total of 48 women with biopsy-proven breast cancer (T 1 -2 , N 0 -2 , M 0 ) were randomised to the control group in which modified radical mastectomy was performed, and the HIFU group in which an extracorporeal HIFU ablation of breast cancer was followed by modified radical mastectomy. Short-term follow-up, pathologic and immunohistochemical stains were performed to assess the therapeutic effects on tumour and complications of HIFU. The results showed that no severe side effect was observed in the HIFU-treated patients. Pathologic findings revealed that HIFU-treated tumour cells underwent complete coagulative necrosis, and tumour vascular vessels were severely damaged. Immunohistochemical staining showed that no expression of PCNA, MMP-9, and CD44v6 was detected within the treated tumour cells in the HIFU group, indicating that the treated tumour cells lost the abilities of proliferation, invasion, and metastasis. It is concluded that, as a noninvasive therapy, HIFU could be effective, safe, and feasible in the extracorporeal treatment of localised breast cancer.

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“…Several machines are under development, two of them being used for the prostate cancer application: the last one is the Sonablate s device (Focus Surgery, IN, USA), with encouraging preliminary results recently published, 12 and the Ablatherm s device (EDAP SA, France), which was evaluated for the past 10 years in Europe, including feasibility, histological, and clinical efficacy studies with long-term results available (Figure 3). …”

Section: Clinical Developmentmentioning

confidence: 99%

Principles and results of high-intensity focused ultrasound for localized prostate cancer

Colombel

Gelet

2004

Prostate Cancer Prostatic Dis

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Focused ultrasound holds promise in a large number of therapeutic applications. It has long been known that high-intensity focused ultrasound (HIFU) can kill tissue through coagulative necrosis. However, it is only in recent years that practical clinical applications are becoming possible, with the development of high-power ultrasound arrays and noninvasive monitoring methods. In the last decade, HIFU have been adapted and used to treat localized prostate cancer and it is now commercially available in Europe. In this article, preclinical studies and clinical development of prostate HIFU as well as early clinical results from our center and international studies are reviewed. Early results demonstrated that prostate HIFU is efficient to obtain local control for low-and intermediate-risk localized prostate cancer; however, long-term follow-up is still needed to estimate the efficacy of prostate HIFU in terms of specific cancer mortality. This makes HIFU a viable alternative in patients not candidate for radical therapy.

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Transrectal high-intensity focused ultrasound for treatment of patients with stage T1b-2n0m0 localized prostate cancer: a preliminary report

Cited by 187 publications

References 23 publications

The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

A randomised clinical trial of high-intensity focused ultrasound ablation for the treatment of patients with localised breast cancer

Principles and results of high-intensity focused ultrasound for localized prostate cancer

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