Treating localized prostate cancer (PCa) with high-intensity focused ultrasound (HIFU) achieves disease-free survival rates similar to those expected with conformal external beam radiation therapy (EBRT), French researchers concluded.

The finding is based on a review of data from 803 men with localized PCa treated with HIFU and had at least two years of follow-up. The men had a mean follow-up of 42 months. The overall and cancer-free survival rates at eight years were 89% and 99%, respectively, Sebastien Crouzet, MD, of Edouard Herriot Hospital in Lyon, and colleagues reported online in European Urology. The metastasis-free survival rate at eight years was 97%. The seven-year biochemical-free survival rate (using Phoenix criteria) was 75%, 63%, and 62% for low-, intermediate-, and high-risk patients.

Using d’Amico criteria, 40.2%, 46.3%, and 13.5% of patients were classified as low, intermediate, and high risk. The mean PSA nadir for the group was 1 ng/mL; 54.3% of men reached a nadir of 0.3 ng/mL or lower. Control biopsies were negative in 85% of cases.

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Dr. Crouzet’s group noted that unlike radiation therapy, HIFU allows an early feedback on treatment efficacy because PSA nadir values are achieved within three to six months after treatment, much sooner than with EBRT. The researchers pointed out that PSA bounce is never observed with HIFU. HIFU can be repeated when necessary several months or several years after the first session and can be followed by salvage radiation treatment.