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Vol. 34. Issue 5.
Pages 403-411 (January 2010)
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Vol. 34. Issue 5.
Pages 403-411 (January 2010)
Extracorporeal high-intensity focused ultrasound: Therapeutic alternative for renal tumors
Ultrasonidos extracorpóreos de alta intensidad: alternativa terapéutica del tumor renal
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J.M. Caballeroa,
Corresponding author
25138jcg@comb.cat

Author for correspondence.
, P. Borrata, M. Parairab, L. Martía, J. Ristola
a Department of Urology, Hospital Mútua Terrassa, Terrassa, Barcelona, Spain
b Department of Radiology, Hospital Mútua Terrassa, Terrassa, Barcelona, Spain
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Abstract
Objective

High-intensity focused ultrasound (HIFU) is currently being used to treat solid tumors in minimally invasive procedures. Transducers allowing for application of ultrasound from an extracorporeal focus have recently been developed. A review of the development, physical principles, and current status of this therapy is provided, and our early experience in treatment of renal tumors with this procedure is reported.

Materials and methods

Extracorporeal HIFU is currently being used for the treatment of tumors (mainly hepatic, gynecological, and bone tumors), and has been started to be used for renal tumors with good results. A literature review (structured search in the online MEDLINE electronic base) of the physical principles of this treatment and its biological action is provided. The therapeutic procedure used in the first few patients with renal carcinoma successfully treated with HIFU at our hospital is reported.

Results

HIFU has been successfully used to treat solid tumors at several centers in Europe, America, and Asia. Our center has a wide experience in the treatment of gynecological tumors using extracorporeal HIFU, and has already treated renal tumors with no complications, although follow-up is still short.

Conclusions

Extracorporeal use of this energy appears as a new option among non-invasive therapies for renal cancer in selected cases. A low complication rate has been reported, but much longer follow-up times are required for assessment of oncological results.

Keywords:
High-intensity focused ultrasound
Tumor ablation
Therapeutic ultrasound
Resumen
Objetivos

Es conocida la aplicación de los ultrasonidos focalizados de alta intensidad (HIFU) en el tratamiento de los tumores sólidos dentro de las terapias mínimamente invasivas, habiéndose desarrollado en los últimos años transductores que permiten la aplicación de ultrasonidos desde un foco extracorpóreo. Presentamos una revisión del desarrollo,los principios físicos, el estado actual y la experiencia inicial propia de esta terapia en el tratamiento de los tumores renales.

Material y métodos

Actualmente el HIFU extracorpóreo está siendo utilizado en el tratamiento de tumores, principalmente hepáticos, ginecológicos y óseos, y se ha iniciado su uso en la terapia para las neoplasias renales con buenos resultados. Presentamos una revisión bibliográfica (búsqueda estructurada en la base electrónica MEDLINE online) de los principios físicos de este tratamiento y su acción biológica. Describimos la metodología de tratamiento de los primeros casos de carcinoma renal tratados en nuestro hospital con éxito mediante HIFU.

Resultados

Esta terapia ha sido empleada con éxito para tratar tumores sólidos en varios centros de Europa, América y Asia. En nuestro centro tenemos una amplia experiencia en el tratamiento mediante HIFU extracorpóreo de tumores ginecológicos, y ya hemos tratado tumores renales sin complicaciones, si bien el seguimiento es todavía corto.

Conclusiones

El uso de esta energía de forma extracorpórea aparece como una nueva opción dentro de las terapias no invasivas del cáncer renal en casos seleccionados, con un escaso índice de complicaciones, aunque hace falta mucho más tiempo de seguimiento para valorar sus resultados desde el punto de vista oncológico.

Palabras clave:
Ultrasonidos de alta intensidad
Ablación tumoral
Ultrasonidos terapéuticos

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