Salvage Radiation Therapy for Localised Prostate Cancer Recurrence Following High-Intensity Focused Ultrasound (HIFU) Failure

IF 1.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology Pub Date : 2025-08-15 DOI:10.1111/1754-9485.70009

Atsuto Katano, Masanari Minamitani, Subaru Sawayanagi, Hideomi Yamashita

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引用次数: 0

Abstract

Introduction

Prostate cancer is a prevalent malignancy with rising incidence rates globally. High-intensity focused ultrasound (HIFU) is a promising, minimally invasive treatment for localised prostate cancer. However, recurrence following HIFU, indicated by rising PSA levels or imaging-confirmed local recurrence, remains a concern. Salvage radiotherapy is a potential treatment for recurrent prostate cancer post-HIFU, but evidence on its efficacy and safety is limited.

Method

This retrospective study evaluated eight patients with localised prostate cancer who underwent salvage radiotherapy following HIFU failure. Salvage treatment consisted of external beam radiation therapy (EBRT), delivered either as conventional fractionation (76 Gy in 38 daily fractions) or stereotactic ablative radiotherapy (36.25–40 Gy in five alternate-day fractions). Outcomes assessed included prostate-specific antigen (PSA) response, biochemical progression-free survival (bPFS), overall survival (OS) and treatment-related toxicity profiles.

Results

All eight patients experienced a significant decline in PSA levels, with no biochemical failures observed during a median follow-up of 72.4 months. The 5-year biochemical failure-free survival and overall survival rates were 100%. Among the eight patients, 6 (75%) had Grade 2 or lower genitourinary toxicity, and 5 (62.5%) had Grade 2 or lower gastrointestinal toxicity, with no Grade 3 or higher adverse events.

Discussion

Salvage EBRT after HIFU failure provides durable disease control with manageable side effects. Further research with larger cohorts is needed to refine treatment strategies for recurrent prostate cancer.

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高强度聚焦超声（HIFU）失败后局部前列腺癌复发的补救性放射治疗。

简介：前列腺癌是一种普遍的恶性肿瘤，全球发病率不断上升。高强度聚焦超声（HIFU）是一种很有前途的微创治疗局部前列腺癌的方法。然而，HIFU后的复发（PSA水平升高或影像学证实的局部复发）仍然值得关注。补救性放疗是hifu后前列腺癌复发的一种潜在治疗方法，但其有效性和安全性的证据有限。方法：回顾性研究8例局部前列腺癌HIFU治疗失败后行补救性放疗的患者。挽救治疗包括外束放射治疗（EBRT），以常规放射治疗（76 Gy，每日38次）或立体定向消融放疗（36.25-40 Gy，隔天5次）的方式进行。评估的结果包括前列腺特异性抗原（PSA）应答、生化无进展生存期（bPFS）、总生存期（OS）和治疗相关毒性概况。结果：在中位72.4个月的随访期间，所有8名患者的PSA水平均显著下降，未观察到生化失败。5年生化无故障生存率和总生存率均为100%。在8例患者中，6例（75%）有2级或更低的泌尿生殖系统毒性，5例（62.5%）有2级或更低的胃肠道毒性，没有3级或更高的不良事件。讨论：HIFU失败后的挽救性EBRT提供持久的疾病控制和可控的副作用。进一步的研究需要更大的队列来完善复发性前列腺癌的治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Medical Imaging and Radiation Oncology 医学-核医学

CiteScore

3.30

自引率

6.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Medical Imaging and Radiation Oncology (formerly Australasian Radiology) is the official journal of The Royal Australian and New Zealand College of Radiologists, publishing articles of scientific excellence in radiology and radiation oncology. Manuscripts are judged on the basis of their contribution of original data and ideas or interpretation. All articles are peer reviewed.