© 2011 Wichtig Editore - ISSN 0391-5603 DOI:10.5301/RU.2011.8523 Urologia ( 2011 ; : 3 ) 180-183 78 180 Ultrasuoni focalizzati ad alta intensità (HIFU): la nostra esperienza nel trattamento del carcinoma prostatico recidivo a radioterapia Luca Giovanessi, Angelo Peroni, Giuseppe Mirabella, Andrea Vismara Fugini, Danilo Zani, Sergio Cosciani Cunico, Claudio Simeone Cattedra e Divisione di Urologia, Spedali Civili di Brescia - Italy High-intensity focused ultrasound (HIFU): our experience in the treatment of prostate cancer relapsing after radiotherapy The aim of the study is to evaluate the safety and efficacy of high-intensity focused ultrasound (HIFU) treatment in patients with local prostate cancer recurrence after radiotherapy. From February 2009 to June 2010, 14 patients with prostate cancer recurrence after radiotherapy were selected for HIFU treatment; all patients had a positive TRUS-guided biopsy and the absence of distant metastases was confirmed by computer tomography, PET choline or bone scintigraphy. We classified all patients in 3 groups using D’Amico’s classification: 4 patients high risk (PSA > 20 ng/ml - 8 ≤ Gleason Score ≤ 10 – clinical stage ≥T2c), 8 patients intermediate risk (10 < PSA ≤ 20 ng/ml – Glea- son Score=7 – clinical stage=T2b), and 2 patients low risk (PSA ≤ 10 ng/ml – Gleason Score≤6 – clini- cal stage=T1c-T2a). Progression was defined using Stuttgart definition (PSA>PSAnadir+1.2ng/ml) or after adjuvant therapy introduction. All complications were recorded. Of the 14 patients selected, 12 patients underwent HIFU treatments; 2 patients were excluded because of rectal strictures induced by radiotherapy. At a mean 13 months’ follow-up, biochemical success rate was obtained in 1 of the high risk patients and in 5 of the low and intermediate risk patients; 1 man died for a disease not cor- related with prostate cancer recurrence. Complications included urinary tract infection, acute urinary retentions, urethral strictures and light stress incontinence. In our experience salvage HIFU is a safe treatment option for local relapse after radiotherapy; its ef- ficacy depends on a careful patient selection. KEY WORDS: High-Intensity Focused Ultrasound, Prostate Cancer, Radiation Failure PAROLE CHIAVE: High-Intensity Focused Ultrasound, Tumore della prostata, Radioterapia Accepted: May 26, 2011 MEETING PROCEEDINGS INTRODUZIONE Il tumore della prostata è attualmente considerato la neo- plasia più frequente nel sesso maschile e la seconda cau- sa di morte per neoplasia (1). Ad oggi la prostatectomia radicale e la radioterapia a fasci esterni sono considerati i trattamenti gold standard per i tumori prostatici localizzati. Secondo le linee guida europee la recidiva locale di neopla- sia prostatica dopo radioterapia è definita dal riscontro di una biopsia prostatica positiva per cellule neoplastiche ad almeno 18 mesi dal trattamento radiante in associazione al riscontro di assenza di metastasi a distanza. Secondo re- centi studi il tasso di recidiva locale di neoplasia prostatica