Sundaram Karthik M, Chang Sam S, Penson David F, Arora Sandeep
Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Semin Intervent Radiol. 2017 Jun;34(2):187-200. doi: 10.1055/s-0037-1602710. Epub 2017 Jun 1.
Therapeutic ultrasound approaches including high-intensity focused ultrasound (HIFU) are emerging as popular minimally invasive alternative treatments for localized, low-to-intermediate risk prostate cancer. FDA approval was recently granted for two ultrasound-guided HIFU devices. Clinical trials for devices using MRI guidance are ongoing. The current level of evidence for whole-gland ultrasound ablation suggests that its clinical efficacy and adverse event rates including erectile dysfunction and urinary incontinence are similar to current definitive therapies such as radical prostatectomy and external-beam radiotherapy. Short-term data suggest that more focal therapy could reduce the rates of adverse events.
包括高强度聚焦超声（HIFU）在内的治疗性超声方法正在成为治疗局限性、低至中度风险前列腺癌的热门微创替代疗法。美国食品药品监督管理局（FDA）最近批准了两款超声引导下的HIFU设备。使用磁共振成像（MRI）引导的设备的临床试验正在进行中。全腺超声消融的现有证据水平表明，其临床疗效和包括勃起功能障碍和尿失禁在内的不良事件发生率与目前的根治性治疗方法（如根治性前列腺切除术和外照射放疗）相似。短期数据表明，更聚焦的治疗可能会降低不良事件的发生率。
