MedWire News: High intensity focused ultrasound (HIFU) is associated with lower prostate-specific antigen (PSA), lower PSA nadir, lower Gleason score, and lower tumor stage compared with baseline, according to a preliminary report by Italian researchers.

However, writing in the Journal of Urology, Luigi Mearini (University of Perugia) and team caution that “as with any novel technology, long-term data will be required before [HIFU] gains widespread clinical acceptance.”

HIFU is one of the most attractive options for the noninvasive treatment of localized prostate cancer in patients with a life expectancy of less than 10 years but with a significant tumor or in patients with a life expectancy of more than 10 years who are not suitable candidates for surgery, the authors explain. Previous studies have shown positive early oncologic outcomes with a favorable side-effect profile.

Mearini and team treated 163 consecutive men (median age, 72 years) with T1–T3 N0M0 prostate cancer using HIFU between 2004 and 2007.

After a median follow-up of 23.8 months, the researchers found that HIFU treatment lead to a decrease in PSA to a median nadir of 0.15 ng/ml.

Median PSA at 3 and 6 months was 0.30 and 0.54 ng/ml, respectively. In addition, the negative biopsy rate at 6 months was 66.1%, and there was no biochemical evidence of disease in 71.9% of patients overall.

“HIFU is a relatively new procedure for prostate cancer treatment and surely it could become a choice for patients with localized prostate cancer,” the authors write.

“As with other minimally invasive treatments patients need to be carefully selected and it could be reserved for patients with low to intermediate risk disease.”

However, the team conclude that “only a more extensive follow-up study, and hopefully a randomized control trial comparing HIFU with other forms of treatment, will definitively place HIFU in the armamentarium of prostate cancer control.”

Free abstract