Lukka Himu, Waldron Tricia, Chin Joseph, Mayhew Linda, Warde Padraig, Winquist Eric, Rodrigues George, Shayegan Bobby
Juravinski Cancer Centre, McMaster University, Hamilton, ON;
Can Urol Assoc J. 2010 Aug;4(4):232-6. doi: 10.5489/cuaj.870.
The aim of this practice guideline was to develop evidence-based recommendations for clinicians on the use of high-intensity focused ultrasound (HIFU) in patients with localized prostate cancer.
The guideline was developed using the methods of Cancer Care Ontario's Program in Evidence-Based Care (PEBC). The core methodology of the PEBC's guideline development process is systematic review. A comprehensive literature search was undertaken to identify high-quality studies, reviews and other practice guidelines on the use of HIFU in prostate cancer. The evidence formed the basis of the recommendations, which were reviewed and amended where necessary, by clinical experts in medical and radiation oncology and urology.
The literature review yielded limited evidence. No randomized controlled trials or meta-analyses comparing HIFU with currently accepted management approaches were identified. The body of evidence is primarily based on data from case series. Internal feedback was provided by the PEBC Genitourinary Disease Site Group membership and the Report Approval Panel. External peer review included targeted review by clinical experts specifically requested to comment on the guideline, and professional consultation through an online survey of health care professionals.
HIFU is currently not recommended as an alternative to accepted curative treatment approaches for localized prostate cancer.
本实践指南旨在为临床医生制定关于高强度聚焦超声（HIFU）用于局限性前列腺癌患者的循证建议。
该指南采用安大略癌症照护循证照护项目（PEBC）的方法制定。PEBC指南制定流程的核心方法是系统评价。进行了全面的文献检索，以识别关于HIFU用于前列腺癌的高质量研究、综述及其他实践指南。这些证据构成了建议的基础，医学、放射肿瘤学和泌尿外科的临床专家对建议进行了审查并在必要时进行了修订。
文献综述获得的证据有限。未识别出比较HIFU与当前公认治疗方法的随机对照试验或荟萃分析。证据主体主要基于病例系列数据。PEBC泌尿生殖疾病领域组成员和报告批准小组提供了内部反馈。外部同行评审包括专门邀请对该指南发表评论的临床专家进行的针对性评审，以及通过对医疗保健专业人员的在线调查进行的专业咨询。
目前不推荐将HIFU作为局限性前列腺癌公认的根治性治疗方法的替代方案。
