The use of high-intensity focused ultrasound (HIFU) for the primary treatment of prostate cancer will probably become more common in the very near future. HIFU has been used for many years in Europe and Mexico and has recently been in clinical trials in the United States. HIFU has been a successful method of prostate cancer treatment, so to assume it will obtain FDA approval in the future is not unreasonable.
Like all other primary prostate cancer treatments a certain number of HIFU treatments will fail and the disease will progress, either coming back in what is left of the treated prostate gland remainder and the surrounding tissue (localized) or in other remote body parts (metastatic).
Radiotherapy is an obvious treatment option in the case of local failure following HIFU treatment. However, prior to establishing radiotherapy as a good salvage treatment option there needs to be studies confirming its efficacy. Such study was performed and its results published in the Journal of European Urology.
This study was designed to evaluate tolerance and oncologic control with salvage radiotherapy (SRT) after HIFU failure and to identify predictive factors of success.
It evaluated men who presented with histologically proven, persistent local prostate cancer following HIFU treatment given from March 1995 to March 2008. All the subjects were treated with curative intent (with or without hormonal treatment) and were included in this single-centre retrospective study.
All subjects were treated with conformal radiotherapy. The median dose of conformal treatment was 72 Gy (65-78 Gy).
The primary outcome measure was progression-free survival (PFS) which was defined as no biochemical relapse (three consecutive rises in prostate-specific antigen