Crouzet S, Poissonnier L, Murat F-J, Pasticier G, Rouvière O, Mège-Lechevallier F, Chapelon J-Y, Martin X, Gelet A
Service d'urologie et chirurgie de la transplantation, hôpital Edouard-Herriot, 5, place d'Arsonval, 69437 Lyon cedex 03, France.
Prog Urol. 2011 Mar;21(3):191-7. doi: 10.1016/j.purol.2010.07.005. Epub 2010 Aug 17.
To report the functional and oncological outcomes of HIFU for prostate cancer using the Ablatherm Integrate Imaging(®) device.
Between January 2005 and June 2009, all patients treated with HIFU as a primary care option for localized prostate cancer and fulfilling the French Urological Association (AFU) guideline were included in this study. Validated questionnaires were used to assess continence, potencies and quality of life.
A total of 297 patients met the inclusion criteria: 149 were low risk and 148 were intermediate risk according to d'Amico's risk group. The median prostate specific antigen (PSA) nadir was 0.12ng/ml with 65% of patients reaching a nadir less than 0.3 ng/ml. Systematic control biopsies were performed on 175 patients with 89% of negative biopsies. The disease free survival rate at 40 months was 79% for low risk group and 62% for intermediate risk group. The pre and post-HIFU treatment International Prostate Symptoms Score (IPSS) score and quality of life questionnaire were not statistically different. In the opposite, the pre and post-HIFU erection function and continence status were significantly different.
Local control and Biochemical Free Survival Rate achieved with HIFU were similar to those expected with conformal external radiation beam therapy. Among the functional outcomes, potency was the most impacted by the treatment.
报告使用Ablatherm Integrate Imaging(®)设备进行高强度聚焦超声（HIFU）治疗前列腺癌的功能和肿瘤学结果。
2005年1月至2009年6月期间，所有将HIFU作为局限性前列腺癌的主要治疗选择且符合法国泌尿外科学会（AFU）指南的患者均纳入本研究。使用经过验证的问卷来评估尿失禁、性功能和生活质量。
共有297例患者符合纳入标准：根据达米科风险分组，149例为低风险，148例为中风险。前列腺特异性抗原（PSA）最低值的中位数为0.12ng/ml，65%的患者最低值低于0.3ng/ml。对175例患者进行了系统性对照活检，其中89%的活检结果为阴性。低风险组40个月时的无病生存率为79%，中风险组为62%。HIFU治疗前后的国际前列腺症状评分（IPSS）和生活质量问卷无统计学差异。相反，HIFU治疗前后的勃起功能和尿失禁状况有显著差异。
HIFU实现的局部控制和无生化复发生存率与适形外照射放疗预期的结果相似。在功能结果方面，性功能受治疗影响最大。
