Efficacy of extracorporeal ultrasound-guided high intensity focused ultrasound: An evaluation based on controlled trials in China

Abstract

Purpose: To evaluate the efficacy of extracorporeal ultrasound-guided high intensity focused ultrasound (HIFU) based upon data in controlled clinical trials in China.

Materials and methods: Data in 75 controlled trials involving in 833 cases of benign and 4559 cases of malignant diseases were re-evaluated.

Results: In uterine fibroid, ectopic pregnancy and chyluria, the efficacy of HIFU was similar to that of surgery or drugs. The survival rate of HIFU plus radiotherapy was less than that of radical surgery in operable liver cancer. In inoperable liver cancer, the survival benefit of HIFU was similar to that of radio frequency, transarterial chemoembolization or γ-knife. In pancreatic cancer, HIFU and chemotherapy produced similar survival rates, and HIFU did not improve the effect of chemotherapy or radiotherapy. HIFU did not enhance hormone therapy in prostate cancer. Preoperative HIFU increased rates of complete removal and of survival in retroperitoneal sarcoma, and increased the response rate in breast cancer. The response rate agreed with the survival benefit (κ = 0.71, p = 0.0002).

Conclusions: HIFU should be curtailed in resectable cases and be an alternative in inoperable cases; a combination regimen should not be recommended. The Response Evaluation Criteria in Solid Tumors can be applied to HIFU.

Keywords::

• Ultrasound-guided high intensity focused ultrasound (HIFU)
• cancer
• benign disease
• clinical benefit

Acknowledgements

This work was supported with grants from the Natural Science Foundation of China (11174376, 31470822) and the State Ministry of Education (SRFDP 20135503130002).

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Supplementary Material Available Online

Supplementary Table 1. List of disease types managed with HIFU.

Supplementary Table 2. The detail of controlled trials in uterine fibroid, ectopic pregnancy and chyluria.

Supplementary Table 3. The detail of controlled trials in liver cancer.

Supplementary Table 4. The detail of controlled trials in pancreatic cancer.

Supplementary Table 5. The detail of controlled trials in gastrointestinal cancer.

Supplementary Table 6. The detail of controlled trials in retroperitoneal lesions, and cancers of breast, prostate and kidney.