Alternative methods of treatment of localized prostate cancer

Neymark A.I., Tachalov M.A., Neymark B.A., Gameeva E.V., Levin V.P.

The aim of the study was to improve the outcomes of treatment of localized prostate cancer (PC) in patients with contraindications for radical methods.

Materials and methods. The studywas based on the data obtained from treating 145 patientswith localized PC,who underwent low-invasive methods of treatment.All patientswere divided into three groups, according to the method of treatment. Patientsfrom the first group (n = 66, 45.5%) had localized PC and underwent HIFU-therapy. Patients with localized PC from the second group (n = 42, 28.9%) underwent HIFU-therapywith the subsequent hormone therapy (HT)in the conditions of maximum androgen blockade during six months. Patients from the third group (n = 37, 25.5%) had localized PC and received superselective X-ray endovascular chemoembolization (CE).

Results. One-year relapse-free survival rate was 95% in the HIFU group and 93% in the HIFU+HT group. Three-year relapse-free survival ratewas 68% in the HIFU group and 88% in the HIFU+HT group. General one-yearsurvivalrate was 100% in all groups. General three-yearsurvival rate was 82% in the CE group, 100% in the HIFU+HT group and 97% in the HIFU group.

Comparative analysis of PSA level revealed that it was significantly lower in those patients who have been receiving HIFU therapy (I and II groups), in comparison with those receiving CE.

The greatest decrease in the volume of the prostate was observed in patients aer HIFU combined with hormone therapy. The tendency towards the increase in the prostate volume was observed in the CE group, with the duration of the monitoring more than 24 months.

Conclusion. The application of HIFU-therapy and chemoembolization for treating localized prostate cancer has demonstrated a good efficiency and safety in case of patients with contraindications for radical methods.

Author declare lack of the possible conflicts of interests.

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prostate cancer, HIFU – therapy, superselective X-ray endovascular embolization,chemoembolization, androgen deprivation therapy

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