Focal Therapy for Prostate Cancer: Current Status of HIFU

Abstract

First choice treatment options for Prostate Cancer (PCa) are Radical Prostatectomy (RP), brachytherapy and pelvic radiation therapy in current guidelines. The aim of this paper was to review effectiveness and oncological results of high intensity frequency ultrasound treatment (HIFU) in patients with localized PCa. HIFU technology is based on a principle of focused ultrasound (US) waves in an area-sized 3x3x11 mm with a convex ultrasound probe. HIFU ablation was first successfully used in 1995 for 29 pre-radical prostatectomy patients with unilateral tumors (T2-T2b). This treatment option mostly used in Europe in US it has not been approved yet by Food and Drug Administration (FDA) and is used only for clinical trials. HIFU is a relatively new treatment method and 10 years of mid-term results for survival were began to emerge. HIFU biopsy success rates are about 80\%. There need to be more accurate and improved results in order to define it as a new definitive treatment option for prostate cancer. Although it has low success rates, it can be used for all risk groups (low, medium, high), it can be used as a rescue treatment after unsuccessful HIFU treatment, radiotherapy and brachytherapy.