英国一项临床试验表明，应用高强度聚焦超声（HIFU）治疗前列腺癌可以获得理想的治疗效果并且减少手术和放疗带来的副作用。
所谓高强度聚焦超声,是指从体外发射超声波到体内,并使其聚焦在特定区域,形成高强度聚焦超声波.而人们所熟悉的B超诊断仪,采用的则是低强度的超声波。应用高强度聚焦超声治疗癌症是近些年新型癌症治疗方法之一。高强度聚焦超声治疗癌症只需要5个小时，而传统的手术加放疗的方法治疗前列腺癌往往要将近一个月时间。
在172个人组成的临床试验小组中，经过治疗后159人（92%）治愈且一年后无复发。只有一人出现尿失禁现象，30～40%阳痿，无肠道出现问题现象。传统的手术加放疗会伴有5～20%的病例出现尿失禁，50%阳痿，还经常导致患者疼痛、出血、腹泻。（生物谷Bioon.com）
生物谷推荐原始出处：
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.
