Objectives: To assess the potential efficacy of the effects of neoadjuvant hormonal therapy on high-intensity focused ultrasound (HIFU) in the treatment of localized prostate cancer.
Methods: One hundred seventy patients with localized prostate cancer underwent HIFU of the prostate, of which 114 patients, who met the study criteria, were included in the current study. The primary outcome was prostate-specific antigen (PSA) changes, and the secondary outcome was morbidity. Biochemical failure was defined according to the Phoenix criteria (prostate-specific antigen nadir +2 ng/ml).
Results: The median follow-up period for all patients was 45.0 months (range: 12-70). All patients underwent PSA evaluation, and 52 (56.5%) had a 2-month PSA nadir recorded at the follow-up visit. PSA nadir was achieved by 3 months in 84.2% of treatments. The mean PSA nadir was 0.28 ng/ml. The 114 patients consisted of two groups: 44 patients treated with neoadjuvant hormonal therapy (group 1), and 70 patients treated without neoadjuvant hormonal therapy (group 2). The mean PSA nadir achieved in group 1 was 0.19 ng/ml versus 0.34 ng/ml in group 2 (n.s.). The occurrence rates of treatment-related toxicities were similar in both groups.
Conclusion: In patients with localized prostate cancer, HIFU therapy resulted in comparable immediate cancer control. The present results indicate that combined treatment using hormonal therapy and HIFU does not have a synergistic effect on the PSA nadir.