A prospective study of salvage high-intensity focused ultrasound for locally radiorecurrent prostate cancer: Early results

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.

Key Words::

• HIFU
• prostate cancer
• salvage treatment

Acknowledgements

The authors acknowledge statistician Lien My Diep at the Research Department, Aker University Hospital, for help in preparation of the manuscript

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