英國一項臨床試驗表明，應(yīng)用高強度聚焦超聲（HIFU）治療前列腺癌可以獲得理想的治療效果并且減少手術(shù)和放療帶來的副作用,。
所謂高強度聚焦超聲,是指從體外發(fā)射超聲波到體內(nèi),并使其聚焦在特定區(qū)域,形成高強度聚焦超聲波.而人們所熟悉的B超診斷儀,采用的則是低強度的超聲波,。應(yīng)用高強度聚焦超聲治療癌癥是近些年新型癌癥治療方法之一,。高強度聚焦超聲治療癌癥只需要5個小時，而傳統(tǒng)的手術(shù)加放療的方法治療前列腺癌往往要將近一個月時間,。
在172個人組成的臨床試驗小組中,，經(jīng)過治療后159人（92%）治愈且一年后無復(fù)發(fā)。只有一人出現(xiàn)尿失禁現(xiàn)象,，30～40%陽痿,，無腸道出現(xiàn)問題現(xiàn)象。傳統(tǒng)的手術(shù)加放療會伴有5～20%的病例出現(xiàn)尿失禁,，50%陽痿,，還經(jīng)常導(dǎo)致患者疼痛、出血,、腹瀉,。（生物谷Bioon.com）
生物谷推薦原始出處：
British Journal of Cancer (2009) 101, 19–26. doi:10.1038/sj.bjc.6605116
High-intensity-focused ultrasound in the treatment of primary prostate cancer: the first UK series
H U Ahmed1, E Zacharakis1, T Dudderidge1, J N Armitage2, R Scott1, J Calleary1, R Illing2,3, A Kirkham3, A Freeman4, C Ogden5, C Allen3 and M Emberton1,2
1Division of Surgery and Interventional Sciences, University College London, 67 Riding House Street, London W1P 7PN, UK
2Clinical Effectiveness Unit, The Royal College of Surgeons of England, 35-43 Lincoln Inn Fields, London, UK
3The Academic Department of Radiology, University College London Hospitals NHS Trust, 235 Euston Road, London NW1 2BU, UK
4The Department of Histopathology, University College London Hospitals NHS Trust, London, UK
5The Royal Marsden Hospital, London, UK
background: The use of minimally invasive ablative therapies in localised prostate cancer offer potential for a middle ground between active surveillance and radical therapy.
methods: An analysis of men with organ-confined prostate cancer treated with transrectal whole-gland HIFU (Sonablate 500) between 1 February 2005 and 15 May 2007 was carried out in two centres. Outcome data (side-effects using validated patient questionnaires, biochemical, histology) were evaluated.
results: A total of 172 men were treated under general anaesthetic as day-case procedures with 78% discharged a mean 5 h after treatment. Mean follow-up was 346 days (range 135–759 days). Urethral stricture was significantly lower in those with suprapubic catheter compared with urethral catheters (19.4 vs 40.4%, P=0.005). Antibiotics were given to 23.8% of patients for presumed urinary tract infection and the rate of epididymitis was 7.6%. Potency was maintained in 70% by 12 months, whereas mild stress urinary incontinence (no pads) was reported in 7.0% (12 out of 172) with a further 0.6% (1 out of 172) requiring pads. There was no rectal toxicity and no recto-urethral fistulae. In all, 78.3% achieved a PSA nadir 0.5 g ml-1 at 12 months, with 57.8% achieving 0.2 g ml-1. Then, 8 out of 13 were retreated with HIFU, one had salvage external beam radiotherapy and four chose active surveillance for small-volume low-risk disease. Overall, there was no evidence of disease (PSA <0.5 g ml-1 or negative biopsy if nadir not achieved) after one HIFU session in 92.4% (159 out of 172) of patients.
conclusion: HIFU is a minimally invasive, day-case ablative technique that can achieve good biochemical outcomes in the short term with minimal urinary incontinence and acceptable levels of erectile dysfunction. Long-term outcome needs further evaluation and the inception of an international registry for cases treated using HIFU will significantly aid this health technology assessment.
