NEW YORK (Reuters Health), Jul 21 - In men with localized prostate cancer, high-intensity focused ultrasound (HIFU) can achieve results comparable to those expected with external-beam radiation therapy, a French group reports.
HIFU is done after transurethral resection of the prostate (TURP). A spherical transducer placed in the rectum generates high-powered ultrasound energy which it directs at a focal point, producing temperatures of 85° C, the authors explain in the July 3 online issue of European Urology.
For the current study, Dr. Sebastien Crouzet at the Universite de Lyon, France, and colleagues enrolled men at clinical stage T1-T2, N0, M0, with no previous prostatectomy or radiation treatment, and no neoadjuvant hormone therapy.
After a mean follow-up of 42 months, they analyzed data on 803 eligible patients.
The study cohort reached a mean prostate specific antigen nadir of 1.0 ng/mL at a mean of 12.9 weeks after HIFU therapy. Mean prostate size fell from 24.5 mL immediately after TURP to 13.6 mL after HIFU.
Random control core biopsies (available for only 589 patients) 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 eight-year metastasis-free survival rate was 97%.
In patients with low-, intermediate-, and high-risk disease, seven-year rates of biochemical-free survival were 75%, 63%, and 62%, respectively. At that point, 79%, 61%, and 54%, respectively, had not undergone any additional treatments.
"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."
Source: link.reuters.com/wet58m
Eur Urol 2010.
Last Updated: 2010-07-20 14:51:22 -0400 (Reuters Health)
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