High-Intensity Focused Ultrasound and Localized Prostate Cancer: Efficacy Results from the European Multicentric Study

Thüroff, S.; Chaussy, C.; Vallancien, Guy; Wieland, W.F.; Kiel, H.; Duc, A. Le; Desgrandchamps, François; Rosette, Jean J.M.C.H. de la; Gelet, A.

doi:10.1089/089277903322518699

Cited by 271 publications

(170 citation statements)

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“…The earliest reported clinical use of HIFU was for treatment of Parkinson's disease (Fry et al 1954). Clinical applications include treatment of renal tumors (Wu et al 2003b;Marberger et al 2005;Kohrmann et al 2002), prostate cancer Thuroff et al 2003;Blana et al 2004), liver cancer (ter Haar et al 1989;Yang et al 1993;Kennedy et al 2004) and breast cancer (Wu et al 2003aGianfelice et al 2004), among others. In the 1980's our research group used HIFU for treatment of glaucoma (Coleman et al 1985;Burgess et al 1986;Silverman et al 1991) and ocular tumors Coleman et al 1986).…”

Section: Introductionmentioning

confidence: 99%

Improved visualization of high-intensity focused ultrasound lesions

Silverman

Muratore

Ketterling

et al. 2006

Ultrasound in Medicine & Biology

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Spectral parameter imaging in both the fundamental and harmonic of backscattered radiofrequency (RF) data was used for immediate visualization of high-intensity focused ultrasound (HIFU) lesion sites. A focused 5-MHz HIFU transducer with a coaxial 9-MHz focused single-element diagnostic transducer was used to create and scan lesions in chicken breast and freshly excised rabbit liver. Bmode images derived from the backscattered RF signal envelope were compared with midband fit (MBF) spectral parameter images in the fundamental (9-MHz) and harmonic (18-MHz) bands of the diagnostic probe. Images of HIFU-induced lesions derived from the MBF to the calibrated spectrum showed improved contrast (~ 3 dB) of tumor margins versus surround compared to images produced from the conventional signal envelope. MBF parameter images produced from the harmonic band showed higher contrast in attenuated structures (core, shadow) compared to either the conventional envelope (3.3 dB core; 11.6 dB shadow) or MBF images of the fundamental band (4.4 dB core; 7.4 dB shadow). The gradient between the lesion and surround was 3.4 dB/mm, 6.9 dB/mm and 17.2 dB/mm for B-mode, MBF-fundamental mode and MBF-harmonic mode respectively. Images of threshold and 'popcorn' lesions produced in freshly excised rabbit liver were most easily visualized and boundaries best defined using MBF-harmonic mode.

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Section: Introductionmentioning

confidence: 99%

Improved visualization of high-intensity focused ultrasound lesions

Silverman

Muratore

Ketterling

et al. 2006

Ultrasound in Medicine & Biology

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“…Longer term results from experienced sites are also available. In a recent report, Gelet and co-workers 16 presented results from 120 patients who were followed up for at least 36 months. In this series, the complete response rate, as defined by negative biopsies and a stable PSA at the nadir value, was 77.4%.…”

Section: Results Of the Multicentric European Studymentioning

confidence: 99%

Principles and results of high-intensity focused ultrasound for localized prostate cancer

Colombel

Gelet

2004

Prostate Cancer Prostatic Dis

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Focused ultrasound holds promise in a large number of therapeutic applications. It has long been known that high-intensity focused ultrasound (HIFU) can kill tissue through coagulative necrosis. However, it is only in recent years that practical clinical applications are becoming possible, with the development of high-power ultrasound arrays and noninvasive monitoring methods. In the last decade, HIFU have been adapted and used to treat localized prostate cancer and it is now commercially available in Europe. In this article, preclinical studies and clinical development of prostate HIFU as well as early clinical results from our center and international studies are reviewed. Early results demonstrated that prostate HIFU is efficient to obtain local control for low-and intermediate-risk localized prostate cancer; however, long-term follow-up is still needed to estimate the efficacy of prostate HIFU in terms of specific cancer mortality. This makes HIFU a viable alternative in patients not candidate for radical therapy.

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“…It is noted that the rate of relapse-free and overall survival of patients with prostate cancer have remained unchanged for several decades (12-24 and 24-36 months respectively) [12]. The second and third lines of hormone therapy, chemotherapy are effective only in 15-20% of cases and does not lead to a significant increase life expectancy of patients, while possessing significant side effects [4,5,6].…”

Section: Discussionmentioning

confidence: 99%

“…While in Russia only 35% of patients are candidates for surgical treatment because of the prevalence of detected tumors, comorbidities and age [2]. Therefore attention of scientists aims is to examine the developed and implemented into clinical practice new effective minimally invasive treatments for prostate cancer such as conformal radiotherapy, brachytherapy, ultrasound ablation and cryotherapy [4]. However, due to the fact that studies analyzing the effectiveness of HIFU-therapy for prostate cancer with a cohort of sufficient size and statistical power is few, the real work done.…”

Section: Introductionmentioning

confidence: 99%

Robotic high-intensity focused ultrasound (rHIFU) for the prostate cancer treatment

Solovov¹,

Шаплыгин²,

Vozdvizhenskiy³

2012

AIP Conference Proceedings

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Abstract.Introduction & Objectives: rHIFU shows a successful treatment for localized prostate cancer (PC). Here we explored the effectiveness of the rHIFU treatment for the prostate cancer, hormone-resistant prostate cancer (HRPC) and failure after external beam radiotherapy (EBRT) and radical prostatectomy (RPE).Materials & Methods: 748 patients were treated in our center between Sep 2007 -February 2012: 137 -hormone-resistance (median time before hormone-resistance 25 months), 286 -received neoadjuvant hormone therapy 6 months, 293 -no treatment before HIFU, 32 -after the EBRT failure. 667 patients underwent TURP+rHIFU, 81 only rHIFU (volume prostate <40cc). Mean follow-up is 38 months (range 3-52). All patients were divided into 3 groups: low risk progression (Gleason <7, stage T1-2N0M0, PSA<20, n= 465), high risk progression -(Gleason ≤9, stage T2-3N0M0, PSA <60, n= 251), after EBRT and RPE failure (n= 39). The mean age of the whole group of patients were 70 (52-89) years, mean prostate volume -39 (5,5-108) cc.Results: Median PSA level 12 months after rHIFU treatment were 0,04 (0-2,24) ng/ml -low risk group, for high risk group -0,5 (0-48,4) ng/ml, with failure after EBRT and RPE-0,5 (0-3,2) ng/ml; 36 months after rHIFU treatment were 0,5 (0,02-3,6) ng/ml -low risk group, for high risk group -3,2 (0-21,38) ng/ml, with failure after EBRT and RPE -1,7 (0-9,8) ng/ml. Patients with low risk had 4,5% of progression, with high risk PC -25%, with failure after EBRT and RPE -19,6%. Kaplan-Meir analyses of the total group indicated that the risk of progression after 1 year follow-up was 10%, the risk of progression was 23% after 4 years of follow-up.Complications: incontinence I -17,5%, incontinence II -7,7%, stricture -18,2%, fistula -0,3 %.Conclusions: Our experience shows that rHIFU ablation is safe, minimally invasive, effective treatment with moderate side effects for the PC, hormone-resistant prostate cancer, rHIFU also may be used as a salvage therapy after EBRF. Further studies are required.

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High-Intensity Focused Ultrasound and Localized Prostate Cancer: Efficacy Results from the European Multicentric Study

Abstract: These short-term results obtained on a large cohort confirm that HIFU is an option to be considered for the primary treatment of localized prostate cancer.

Cited by 271 publications

References 9 publications

Improved visualization of high-intensity focused ultrasound lesions

Improved visualization of high-intensity focused ultrasound lesions

Principles and results of high-intensity focused ultrasound for localized prostate cancer

Robotic high-intensity focused ultrasound (rHIFU) for the prostate cancer treatment

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