Transperineal laser ablation (TPLA) with ultrasound/MRI fusion guidance in the treatment of localized radiotherapy-resistant prostate cancer.

BJR open Pub Date : 2023-10-18 eCollection Date: 2023-01-01 DOI:10.1259/bjro.20230042
Guglielmo Manenti, Marco Nezzo, Colleen Patricia Ryan, Federico Romeo Fraioli, Beatrice Carreri, Paola Elda Gigliotti, Cecilia Angeloni, Francesca Di Pietro, Martina De Angeli, Tommaso Perretta, Rolando Maria D'Angelillo, Francesco Giuseppe Garaci
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Abstract

Objective: The objective of this study was to assess the technical feasibility, safety, and efficacy of transperineal laser ablation (TPLA) guided by ultrasound/magnetic resonance (MR) fusion as a salvage treatment for refractory focal prostate cancer.

Methods: A total of five patients who had undergone radiation therapy (RT) for prostate carcinoma and biochemical recurrence, confirmed by both prostate-specific antigen (PSA) levels and MRI (3T mpMRI), were enrolled in this study. Focal ablation was performed using a 1064 nm diode laser. Post-ablation follow-up was conducted for a duration of 18 months, which included regular PSA sampling, 3T mpMRI, and ultrasound/MR fusion-guided biopsies systematic and targeted at the site of the focal treatment.

Results: The focal ablation procedure was carried out in an outpatient setting regimen with optimal clinical and biochemical outcomes. No recurrence was detected throughout the follow-up period.

Conclusion: TPLA focal treatment effectively manages local recurrences of RT refractory prostate cancer without side-effects or complications. Preservation of quality of life and functional outcomes, along with a >70% reduction in PSA, were achieved.

Advances in knowledge: Our study investigated TPLA as a salvage treatment for low-risk recurrent prostate cancer after RT, demonstrating its tolerability, feasibility, and effectiveness.

Abstract Image

Abstract Image

Abstract Image

超声/MRI融合引导下经阴部激光消融(TPLA)治疗局部放疗耐药前列腺癌症。
目的:本研究旨在评估超声/磁共振(MR)融合经盆腔激光消融(TPLA)治疗难治性局灶性癌症的技术可行性、安全性和有效性。方法:共有5名接受前列腺癌放射治疗(RT)和生化复发的患者,经前列腺特异性抗原(PSA)水平和MRI(3T-mpMRI)证实,纳入本研究。使用1064 nm二极管激光器。消融后随访持续18个月,包括定期PSA采样、3T-mpMRI和超声/MR融合引导的活检,系统地并靶向病灶治疗部位。结果:局灶性消融术是在门诊环境下进行的,具有最佳的临床和生化结果。随访期间未发现复发。结论:TPLA局部治疗能有效控制RT难治性癌症的局部复发,无副作用和并发症。生活质量和功能结果得到了保护,PSA降低了70%以上。知识进展:我们的研究调查了TPLA作为RT后低风险复发性前列腺癌症的挽救性治疗方法,证明了其耐受性、可行性和有效性。
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