Yu T, Li X. Clinical Trials of High-intensity Focused Ultrasound for Cancer: Concerns Arising from Low Post-Hoc Power.
Curr Med Chem 2025;
32:2-5. [PMID:
38323616 DOI:
10.2174/0109298673281773240104142757]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/10/2023] [Accepted: 12/22/2023] [Indexed: 02/08/2024] [Imported: 04/03/2025]
Abstract
Prospective controlled trials of high-intensity focused ultrasound (HIFU) for cancers were evaluated. Post-hoc power was <0.80 in 30/46 trials and in 22/38 trials with positive results, indicating low quality in most trials. Unscientific endpoints, small sample sizes, and high dropout rates led to low post-hoc power that caused inter-trial heterogeneity and overestimated the therapeutic effect. The objective response rate was not a substitute for survival time for estimating the sample size and assessing the efficacy. The present data can interpret a paradox: HIFU is considered to have slighter cytotoxicity to noncancer tissues and no radiation but is frequently combined with chemotherapy and/or radiotherapy in practice.
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