Focused Ultrasound Therapy
Focused ultrasound is a therapeutic technology that could transform the quality of life and decrease the cost of care for patients with the many types of predominantly soft tissue sarcomas. The morphology of how these are combated is quite different from osteosarcoma, which is covered in a separate document. There are many types of sarcomas, including 70 different subtypes. Common ones include: rhabdomyosarcoma, synovial sarcoma, and undifferentiated pleomorphic sarcoma. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging the surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound produces several therapeutic effects that are being evaluated. One is the use of thermal ablation, which the energy does not harm the local tissue, but at the point of ultrasound beam convergence, the target gets very hot and leads to localized tissue destruction. Another technique uses mechanical histotripsy in a non-thermal way to disrupt and lead to a slurry of cellular debris from the targeted tissue. There are several other ways that focused ultrasound can be configured to deliver treatment for this disease.
The primary options for treatment of sarcoma often includes medication and invasive surgery, and at times, amputation.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications and lower cost.
Advantages
- Focused ultrasound is non-invasive, so it does not carry added concerns like surgical wound healing or infection.
- Focused ultrasound can reach the desired target without damaging surrounding tissue.
- It can be repeated, if necessary.
Clinical Trials
There is a clinical trial for those with undifferentiated, pleomorphic sarcoma in California.
There is a clinical trial for those with a wide variety of soft tissue sarcomas (including all of these: malignant fibrous histiocytoma, undifferentiated (pleomorphic) sarcoma, fibrosarcoma and fibromyxoid sarcoma (fibroblastic sarcomas), leiomyosarcoma, liposarcoma, malignant peripheral nerve sheath tumor, retroperitoneal sarcoma, rhabdomyosarcoma, and synovial sarcoma).
Regulatory Approval and Reimbursement
Focused ultrasound treatment for sarcoma is not approved by regulatory bodies and is not likely to be covered by medical insurance companies.
Notable Papers
Laganà AS, Romano A, Vanhie A, Bafort C, Götte M, Aaltonen LA, Mas A, De Bruyn C, Van den Bosch T, Coosemans A, Guerriero S, Haimovich S, Tanos V, Bongers M, Barra F, Al-Hendy A, Chiantera V, Leone Roberti Maggiore U. Management of Uterine Fibroids and Sarcomas: The Palermo Position Paper. Gynecol Obstet Invest. 2024;89(2):73-86. doi: 10.1159/000537730. Epub 2024 Feb 21. PMID: 38382486
Zhu YQ, Zhao GC, Zheng CX, Yuan L, Yuan GB. Managing spindle cell sarcoma with surgery and high-intensity focused ultrasound: A case report. World J Clin Cases. 2023 Sep 26;11(27):6551-6557. doi: 10.12998/wjcc.v11.i27.6551. PMID: 37900255
Click here for additional references from PubMed.