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Prostate Focused Ultrasound Therapy.

Jean-Yves Chapelon1,2, Olivier Rouvière3,4,5, Sébastien Crouzet3,4,6

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High-Intensity Focused Ultrasound (HIFU) offers an effective treatment for prostate cancer (PCa), showing promise as a focal therapy. HIFU is suitable for primary treatment and after radiation failure, with outcomes comparable to surgery but fewer side effects.

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Area of Science:

  • Urology
  • Oncology
  • Medical Engineering

Background:

  • Prostate cancer (PCa) is a common cancer in men, with High-Intensity Focused Ultrasound (HIFU) emerging as a significant therapeutic option.
  • Advances in engineering, computing, and ultrasound technology have driven renewed clinical interest in HIFU therapy over the last two decades.
  • HIFU has been clinically used for over 15 years, primarily for transrectal prostate ablation in localized PCa.

Purpose of the Study:

  • To review the current status and potential of High-Intensity Focused Ultrasound (HIFU) in treating prostate cancer (PCa).
  • To evaluate HIFU's efficacy as a primary treatment and in cases of external beam radiotherapy (EBRT) failure.
  • To explore HIFU's suitability for focal therapy in PCa management.

Main Methods:

  • HIFU treatment is performed under real-time ultrasound or MRI guidance.
  • Treatment can be administered as a standalone therapy or in conjunction with external beam radiotherapy (EBRT).
  • HIFU can be repeated and is being explored for focal treatment strategies.

Main Results:

  • HIFU demonstrates effectiveness for primary treatment of localized PCa, with outcomes comparable to standard conformal EBRT.
  • Salvage HIFU after EBRT failure shows oncological outcomes similar to surgery but with a reduced adverse effect profile.
  • HIFU is well-suited for focal therapy, with outcomes and toxicity directly related to the treated prostate volume.

Conclusions:

  • HIFU is a validated and evolving therapeutic option for prostate cancer, offering benefits in both primary treatment and salvage settings.
  • The technology's adaptability for focal treatment makes it a promising avenue for precise PCa management.
  • Further research, including randomized comparative studies and long-term follow-up, is needed to fully establish HIFU's role.