High-intensity focused ultrasound therapy of prostate cancer local recurrence

Sivkov A.V., Roschin D.A., Keshishev N.G., Shaderkin I.A., Coy A.A.

This literature review is dedicated to the problem of prostate cancer local recurrence. Prostate cancer takes one of the leading places in the structure of cancer incidence and mortality. With an aging population, the number of such patients will only increase. Modern radical treatments have a high, but not sufficient efficiency. Relapse after radical prostatectomy, is observed in 29% – 40% of patients within the next 10 years after surgery. After external beam radiotherapy relapse during the first 5 years is observed in 31% – 46% of patients and after brachytherapy in 17% – 29% of patients. The comparative characteristics of the existing methods of treatment of prostate cancer local recurrence after radical treatment are given. The results of salvage radical prostatectomy, brachytherapy and cryoablation are represented. As far as oncological and functional results, major complications. Salvage radical prostatectomy, with 55 – 69% 5-year disease-free survival rate is associated with a high risk of intra-and postsurgical complications. With 40% 5-year disease-free survival rate after salvage cryoablation large numbers of complications, often related to the violation of urination are observed. When disease-free 3-and 5-year survival rates after salvage brachytherapy are 48% and 34%, respectively. A brief history of high intensive focused ultrasound therapy method is given. The results of various studies of prostate cancer local recurrence HIFU-treatment after radiation treatments are described. Thus disease free survival rate according to two studies in the first five years may reach 53% and has a risk dependence. There are very few publications of HIFU-treatment of local recurrence after radical prostatectomy. Thus, according to the results of 4 studies, where only 54 patients participated, in the early stages of observation authors conclude the relative safety of the method, since no signoficant complications were met, despite the fact that in some patients HIFU-therapy was performed again. The short period of observation and the small number of patients does not allow to make specific conclusions about the effeciency of this method in patients with local recurrence of prostate cancer aer radical prostatectomy.

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