High-intensity focused ultrasound for prostate cancer: a practice guideline

Authors

  • Himu Lukka Juravinski Cancer Centre, McMaster University, Hamilton, ON
  • Tricia Waldron McMaster University, Hamilton, ON
  • Joseph Chin London Health Sciences Centre and University of Western Ontario, London, ON
  • Linda Mayhew McMaster University, Hamilton, ON
  • Padraig Warde Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, ON
  • Eric Winquist London Health Sciences Centre and University of Western Ontario, London, ON
  • George Rodrigues London Health Sciences Centre and University of Western Ontario, London, ON
  • Bobby Shayegan St. Joseph’s Healthcare, McMaster University, Hamilton, ON

DOI:

https://doi.org/10.5489/cuaj.870

Abstract

Objective: The aim of this practice guideline was to develop
evidence-based recommendations for clinicians on the use of
high-intensity focused ultrasound (HIFU) in patients with localized
prostate cancer.

Methods: The guideline was developed using the methods of
Cancer Care Ontario’s Program in Evidence-Based Care (PEBC).
The core methodology of the PEBC’s guideline development process
is systematic review. A comprehensive literature search was
undertaken to identify high-quality studies, reviews and other practice
guidelines on the use of HIFU in prostate cancer. The evidence
formed the basis of the recommendations, which were reviewed
and amended where necessary, by clinical experts in medical and
radiation oncology and urology.

Results: The literature review yielded limited evidence. No randomized
controlled trials or meta-analyses comparing HIFU with
currently accepted management approaches were identified. The
body of evidence is primarily based on data from case series.
Internal feedback was provided by the PEBC Genitourinary Disease
Site Group membership and the Report Approval Panel. External
peer review included targeted review by clinical experts specifically
requested to comment on the guideline, and professional
consultation through an online survey of health care professionals.

Conclusion: HIFU is currently not recommended as an alternative to
accepted curative treatment approaches for localized prostate cancer.

Objectif : Le but de ce guide de pratique était d’élaborer des recommandations
factuelles pour les cliniciens concernant l’emploi
d’ultrasons ciblés de haute intensité (HIFU) dans le traitement du
cancer de la prostate localisé.

Méthodologie : Le guide de pratique a été élaboré à l’aide de
la méthodologie préconisée par Action Cancer Ontario dans son
Programme de soins fondés sur la recherche (PSFR). La métho–
dologie centrale pour l’élaboration de lignes directrices selon ce
programme repose sur un examen systématique. Des recherches
exhaustives ont été effectuées dans les publications afin de cerner
des études de haute qualité, des articles de synthèse et d’autres
lignes directrices de pratique sur l’emploi de la technique HIFU
dans le traitement du cancer de la prostate. Les données dégagées
ont formé la base des recommandations, qui ont ensuite été examinées
et modifiées, si nécessaire, par des cliniciens experts en oncologie
médicale, en radio-oncologie et en urologie.

Résultats : La revue de la littérature n’a permis de dégager que
des données limitées. Aucun essai clinique avec randomisation
ni aucune méta-analyse comparant la technique HIFU à des techniques
de traitement actuellement acceptées n’ont été cernés.
L’ensemble des données est fondé surtout sur des séries de cas. Des
commentaires internes provenaient des membres du groupe sur les
maladies génito-urinaires du PSFR et du Comité d’approbation du
rapport. L’examen externe par des pairs incluait un examen ciblé
par des cliniciens experts à qui on avait demandé spécifiquement
de commenter le guide de pratique, et par des professionnels de
la santé par le biais de consultations professionnelles en ligne.

Conclusion : La technique HIFU n’est actuellement pas recommandée
comme traitement de rechange aux techniques actuellement
acceptées pour le traitement du cancer de la prostate localisé.

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Author Biographies

Himu Lukka, Juravinski Cancer Centre, McMaster University, Hamilton, ON

Tricia Waldron, McMaster University, Hamilton, ON

Joseph Chin, London Health Sciences Centre and University of Western Ontario, London, ON

Linda Mayhew, McMaster University, Hamilton, ON

Padraig Warde, Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, ON

Eric Winquist, London Health Sciences Centre and University of Western Ontario, London, ON

George Rodrigues, London Health Sciences Centre and University of Western Ontario, London, ON

Bobby Shayegan, St. Joseph’s Healthcare, McMaster University, Hamilton, ON

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How to Cite

Lukka, H., Waldron, T., Chin, J., Mayhew, L., Warde, P., Winquist, E., … Shayegan, B. (2013). High-intensity focused ultrasound for prostate cancer: a practice guideline. Canadian Urological Association Journal, 4(4), 232–6. https://doi.org/10.5489/cuaj.870

Issue

Vol. 4 No. 4 (2010): CUAJ August

Section

Techniques in urology

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