Curing PCa with Ultrasound
High-intensity focused ultrasound comparable to open surgery.
Although the study was not a randomized comparison of HIFU and radical prostatectomy, “HIFU therapy is an easy, safe, repeatable, and minimally invasive treatment,” said
Dr. Asano and his colleagues at
Quality-of-life (QOL) measures were assessed pretreatment and six months post-treatment using the International Prostate Symptom Score (IPSS) and the Functional Assessment of Cancer Therapy-General Prostate (FACT-G, P).
Patients' initial median PSA level was 10.5 ng/mL. Thirty-five patients had stage T1c prostate cancer, 11 had stage T2a, 6 had stage T1b, and 4 had stage T2b. The Gleason score ranged from 5-9, with 7 being the most commonscore (28 men). Twenty-one of the patients had hormonal therapy previously, eight underwent transurethral resection of the prostate, and five had a previous HIFU.
There were no major complications associated with treatment and no intraoperative complications. Post-operative complications at six months were dysuria in four patients (7.1%) and urethral stenosis in two (3.6%).
At six months, prostate biopsies were negative in 54 of the 56 patients (96.3%). Fifty-three patients had a follow-up MRI, which revealed no remarkable change in any patient. Thirty-three patients had a change in PSA level of less than 1.0 ng/mL, 15 had a change of 1.0-3.9 ng/mL, and eight had a change of 4.0 ng/mL or greater. The complete response rate was 83.9% (47 of 56) using Gelet's criteria.
There were also no significant changes from pretreatment to six months post-treatment in the IPSS, and mean scores on the FACT-Prostate scale did not change significantly.