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HIFU in der Uro-Onkologie

HIFU in urological oncology

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Zusammenfassung

Das Interesse an der Technologie des „hochintensiven fokussierten Ultraschalls“ (HIFU) ist vor allem auf dessen nichtinvasiven Therapiecharakter zurückzuführen. In der urologischen Onkologie findet HIFU als therapeutische Maßnahme zur Behandlung des Prostata- und Nierenkarzinoms Anwendung. Während die Therapie des Nierenkarzinoms noch in experimentellen und klinischen Studien geprüft wird, ist die Therapie mit HIFU in vielen Zentren Europas und darüber hinaus als Therapie des Prostatakarzinoms bereits etabliert. Die Ergebnisse der Therapie des Prostatakarzinoms mit HIFU beruhen in der Hauptsache auf Patientenserien unterschiedlicher klinischer Studien. In den USA wurde vor ca. 1/2 Jahr eine prospektive Multicenterstudie im Vergleich zur Cryotherapie zur Erreichung der klinischen Zulassung (FDA approval) begonnen. Die neuesten Publikationen sehen in der transrektalen HIFU-Therapie eine erfolgversprechende Option bei hoch- und mitteldifferenzierten Tumoren, bei lokalen Rezidiven erfolgloser anderer Primärtherapien und als unterstützende auxiliäre palliative Therapiemöglichkeit des systemischen Prostatakarzinoms.

Abstract

The growing interest in high-intensity focused ultrasound (HIFU) technology is mainly due to its many potential applications as a new energy source and as noninvasive therapy. It has been introduced to urological oncology as a transrectal treatment for prostate cancer and as extracorporeal treatment for kidney cancer. Although its application in the kidney is still at the clinical feasibility phase, HIFU technology is currently being used in daily practice in Europe for the treatment of prostate cancer. Reports in the literature describing results of HIFU for prostate cancer are mainly based on monocentric, prospective clinical studies. The latest published results suggest that HIFU treatment is a valuable option for well-differentiated and moderately differentiated tumors, as well as for local recurrence after external beam radiation. Two different devices for transrectal treatment of prostate cancer are available, which are essentially different in technology, application mode, published results, and side effects.

HIFU in locally recurrent cancer after surgery, as well as adjuvant HIFU for local debulking in locally advanced or metastatic disease, shows promising first results for reducing local disease-induced morbidity and for delay of progression.

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Der korrespondierende Autor weist auf folgende Beziehung hin: Referententätigkeit für die Firma EDAP.

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  1. Urologische Klinik, Klinikum Harlaching, Sanatoriumsplatz 2, 81545, München, Deutschland

    S. Thüroff &  C. Chaussy

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  1. S. Thüroff
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  2. C. Chaussy
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Correspondence to S. Thüroff.

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Thüroff, S., Chaussy, C. HIFU in der Uro-Onkologie. Urologe 47, 431–440 (2008). https://doi.org/10.1007/s00120-008-1658-9

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