[Salvage high energy focalized ultrasound (HIFU) in prostate cancer after radiotherapy].
OBJECTIVE
To evaluate the efficacy and safety of High Intensity Focused Ultrasound (HIFU) as salvage treatment after radical radiotherapy in prostate cancer (PC).


METHODS
We reviewed the literature through databases and published articles that refer to this treatment between 2000 and 2010. We evaluated oncological results and adverse effects, compared with those published in conjunction with other therapies.


RESULTS
We evaluated the different series, which include the results of the two devices currently available, all with their initial results and those that are in the process of dose adjustment. Generally, it can be said that the biggest problem of all is that initial morbidity is reduced as the surgeon gains experience with the treatment. We must stress the importance of the short series that are evaluated, especially in follow-up time and number of patients. Also, except for a recently published systematic review, no prospective studies are published. The results from different series are compared with existing literature regarding to other PC treatments.


CONCLUSIONS
In spite of published results, the treatment with HIFU for prostate cancer recurrence after radiotherapy is an option that should be considered. Especially considering that, it is important to delay the development of the disease in these patients, and there are no other alternatives that have proven to be effective. Further research is needed to explore the use of HIFU in the treatment of PC. Anyway, it is essential to publish comparative prospective series and series with more patients and longer follow-up to draw definitive conclusions.
Urología Clínica, Clínica Virgen Blanca, Bilbao, España.
Mikel
M
Gamarra
Ander
A
Astobieta
José Gregorio
JG
Pereira
Asier
A
Leibar
Gaspar
G
Ibarluzea
D004867:Equipment Design; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D016879:Salvage Therapy; D036761:Ultrasound, High-Intensity Focused, Transrectal / Q000295:instrumentation