A Prospective Study of Salvage High-Intensity Focused Ultrasound for Locally Radiorecurrent Prostate Cancer: Early Results

Scand J Urol Nephrol. 2010 Sep;44(4):223-7. doi: 10.3109/00365591003727551.

Abstract

Objective: After radical external beam radiation therapy (EBRT), local recurrence may benefit from definitive local therapy. The objective of this study was to evaluate the safety and short-term biochemical results and morbidity after salvage high-intensity focused ultrasound (HIFU) treatment in patients with biopsy-proven local prostate cancer recurrence after EBRT.

Material and methods: From October 2006 46 patients were treated with HIFU. Bone scan and abdominal CT/MRI scan were negative. Median follow-up was 9 months (range 3-24 months).

Results: The median prostate-specific antigen (PSA) nadir was 0.3 ng/ml (range 0-24 ng/ml). Eighteen patients (39.1%) were classified as failures. In addition, there were four patients (8.7%) with post-HIFU PSA nadir > 0.5 ng/ml. No patients died during follow-up. One patient developed urethrorectal fistulae and was successfully treated conservatively. Two patients developed urethrocutaneous fistulae. Seven patients (15.2%) and one patient (2.1%) developed grade 2 and grade 3 incontinence, respectively. Seven men (15.2%) had erectile function sufficient for intercourse pre-HIFU and only two men (4.3%) post-HIFU.

Conclusions: Early results of salvage HIFU in patients with local recurrence of prostate cancer after radical EBRT indicate the procedure to be a reasonable treatment option, but better patient selection criteria are needed. The side-effects are not negligible.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / prevention & control*
  • Prospective Studies
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / therapy*
  • Retrospective Studies
  • Salvage Therapy / methods*
  • Treatment Failure
  • Treatment Outcome
  • Ultrasound, High-Intensity Focused, Transrectal / methods*

Substances

  • Prostate-Specific Antigen