HIFU
- Clinical Trials and Statistics
Clinical Trials
1. Hemi-ablation Study, Mr Mark Emberton, UCLH
This is a clinical study looking at the possibility of treating
one side of the prostate only; in men with disease on just
one side. Patients will be followed up to be sure
that the cancer is treated successfully.
It is expected that men will avoid significant side
effects such as erectile dysfunction by having just one
side of the prostate treated. |
|
 |
2. Focal Ablation of Early Stage Prostate Cancer, Mr Mark
Emberton, UCLH
This exciting study is examining the possibility of treating
cancerous tumours on either or both sides of the prostate, whilst
treating a minimum of healthy prostate tissue. Men will
be closely followed up to confirm that the cancer has been successfully
treated. Men should experience little or no side effects.
3. Prostate HIFU to treat patients who have failed radiotherapy,
Mr Simon Brewster, Oxford Churchill.
This study will assess the outcome of prostate HIFU in men who
have already been treated by radiotherapy, but experience
a recurrence of prostate cancer. The study is only open
to men who have cancer contained within the prostate. It
is expected that the side effects of treatment will be higher
than men who have a primary HIFU treatment. The centres
involved in the study are;
1. Basingstoke - Mr Richard Hindley
2. Bristol - Mr R Persad and Mr D Gillatt
3. Derby - Mr Mike Henley
4. Glasgow - Professor Hing Leung
5. London - Mr M Emberton and Mr C Ogden
6. Oxford - Mr Simon Brewster
Focal Therapy with High-Intensity-Focused
Ultrasound in the Treatment of Localized Prostate Cancer –
Abstract
Monday, 25 February 2008
Department of Urology, Teikyo University School of Medicine, Tokyo,
Japan.
We evaluated the efficacy and feasibility of high-intensity-focused
ultrasound (HIFU) for localized prostate cancer.
Seventy patients received HIFU using Sonablate((R)) 500 (Focus
Surgery, IN, USA). In patients whose cancer was confined to only
one lobe by multi-regional biopsies, total peripheral zone and
a half portion of transitional zone were ablated (focal therapy).
Otherwise, patients received whole organ ablation (whole therapy).
Scheduled biopsies were performed at 6 and 12 months after treatment.
Pre- and post-HIFU serum testosterone levels were measured.
The 2-year biochemical disease-free survival (DFS) rates in patients
at low, intermediate and high risk were 85.9, 50.9 and 0%, respectively,
(P = 0.0028). After 12 months, 81.6% (40/49) of patients were
biopsy negative; 84.4% in patients who received whole therapy,
whereas 76.5% in those with focal therapy. The 2-year biochemical
DFS rates for the patients at low and intermediate risk was 90.9
and 49.9%, respectively, in patients with whole therapy, whereas
83.3 and 53.6% in patients with focal therapy. In patients without
neoadjuvant androgen deprivation, serum testosterone levels continuously
decreased after whole therapy, whereas no changes were seen in
those with focal therapy. The patients whose follow-up biopsies
were positive tended to have significantly higher changes in prostate-specific
antigen levels than biopsy-negative patients.
In patients with low-risk prostate cancer, HIFU monotherapy resulted
in comparable immediate cancer control with other modalities.
Particularly, focal therapy might offer a feasible minimally invasive
therapeutic option, which maintained serum testosterone level.
To our knowledge, this is the first report that whole, but not
focal, therapy affects the serum testosterone level.
Written by
Muto S, Yoshii T, Saito K, Kamiyama Y, Ide H, Horie S.
Reference
Jpn J Clin Oncol. 2008 Feb 15. Epub ahead of print.
doi:10.1093/jjco/hym173
PubMed Abstract
PMID:18281309
