Laser-focused ablative therapy for prostate cancer and benign prostatic hyperplasia: A review of current applications and future directions.

IF 4.9 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
François Cornud, Eric M Walser, Katelijne Cc de Bie, Arnaud Lefevre, Marc Galiano
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引用次数: 0

Abstract

Focal Laser ablation (FLA), or interstitial Laser thermotherapy, is a promising minimally invasive approach for the treatment of localized prostate cancer and benign prostatic hyperplasia. This technique is gaining popularity among patients due to its ability to preserve pre-treatment quality of life. The examination is performed under magnetic resonance imaging (in bore) or ultrasound guidance, via a percutaneous transrectal or transperineal route. Under transperineal ultrasound guidance, FLA can use up to four Laser fibers to create confluent zones of tissue ablation, enabling treatment of larger prostate- or tumor volumes. Primary indications for FLA include intermediate-risk localized prostate cancer and benign prostatic hyperplasia refractory to medical treatment due to ineffectiveness or side effects. The intervention is typically performed under light sedation or under locoregional anesthesia. FLA lasts approximately 10 min, with a total intervention time of < 60 min on an outpatient basis. Patients are often discharged with either a suprapubic or bladder catheter to prevent urinary retention, especially if the ablated area is close to the urethra. Minor complications are rare and limited to transient voiding dysfunction, urinary tract infection, or hematuria. Major complications, such as rectoprostatic fistula, are avoided by rectoprostatic hydrodissection. FLA is an effective, well-tolerated option in the minimally invasive treatment of prostate disease, offering rapid treatment times, low complication rates, and preservation of quality of life for appropriately selected patients. However, variability in recurrence rates following FLA for prostate cancer highlights the need for further investigation into optimal patient selection for this treatment.

激光聚焦消融治疗前列腺癌和良性前列腺增生:目前的应用和未来的发展方向综述。
局部激光消融(FLA)或间质激光热疗是治疗局限性前列腺癌和良性前列腺增生的一种很有前途的微创方法。这项技术在患者中越来越受欢迎,因为它能够保持治疗前的生活质量。检查在磁共振成像(钻孔)或超声引导下进行,通过经皮经直肠或经会阴途径。在经会阴超声引导下,FLA可以使用多达四根激光纤维来创建组织消融的融合区,从而可以治疗更大的前列腺或肿瘤体积。FLA的主要适应症包括中度危险的局限性前列腺癌和因无效或副作用而难以药物治疗的良性前列腺增生。干预通常在轻度镇静或局部麻醉下进行。FLA持续约10分钟,在门诊的基础上,总干预时间< 60分钟。患者出院时通常使用耻骨上导尿管或膀胱导尿管,以防止尿潴留,特别是当消融区域靠近尿道时。轻微的并发症是罕见的,仅限于短暂的排尿功能障碍,尿路感染,或血尿。主要的并发症,如直肠前列腺瘘,可避免直肠前列腺水解剖。FLA在前列腺疾病的微创治疗中是一种有效且耐受性良好的选择,为适当选择的患者提供快速的治疗时间,低并发症发生率,并保留生活质量。然而,前列腺癌FLA术后复发率的可变性强调了进一步研究这种治疗的最佳患者选择的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diagnostic and Interventional Imaging
Diagnostic and Interventional Imaging Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
8.50
自引率
29.10%
发文量
126
审稿时长
11 days
期刊介绍: Diagnostic and Interventional Imaging accepts publications originating from any part of the world based only on their scientific merit. The Journal focuses on illustrated articles with great iconographic topics and aims at aiding sharpening clinical decision-making skills as well as following high research topics. All articles are published in English. Diagnostic and Interventional Imaging publishes editorials, technical notes, letters, original and review articles on abdominal, breast, cancer, cardiac, emergency, forensic medicine, head and neck, musculoskeletal, gastrointestinal, genitourinary, interventional, obstetric, pediatric, thoracic and vascular imaging, neuroradiology, nuclear medicine, as well as contrast material, computer developments, health policies and practice, and medical physics relevant to imaging.
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