Comparative Effectiveness of Radiotherapy versus Focal Laser Ablation in Patients with Low and Intermediate Risk Localized Prostate Cancer

Biocompatible gold nanoparticles designed to absorb light at wavelengths of high tissue transparency have been of particular interest for biomedical applications. The ability of such nanoparticles to convert absorbed near-infrared light to heat and induce highly localized hyperthermia has been shown to be highly effective for photothermal cancer therapy, resulting in cell death and tumor remission in a multitude of preclinical animal models. Here we report the initial results of a clinical trial in which laser-excited gold-silica nanoshells (GSNs) were used in combination with magnetic resonance–ultrasound fusion imaging to focally ablate low-intermediate-grade tumors within the prostate. The overall goal is to provide highly localized regional control of prostate cancer that also results in greatly reduced patient morbidity and improved functional outcomes. This pilot device study reports feasibility and safety data from 16 cases of patients diagnosed with low- or intermediate-risk localized prostate cancer. After GSN infusion and high-precision laser ablation, patients underwent multiparametric MRI of the prostate at 48 to 72 h, followed by postprocedure mpMRI/ultrasound targeted fusion biopsies at 3 and 12 mo, as well as a standard 12-core systematic biopsy at 12 mo. GSN-mediated focal laser ablation was successfully achieved in 94% (15/16) of patients, with no significant difference in International Prostate Symptom Score or Sexual Health Inventory for Men observed after treatment. This treatment protocol appears to be feasible and safe in men with low- or intermediate-risk localized prostate cancer without serious complications or deleterious changes in genitourinary function.

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SBRT for the Primary Treatment of Localized Prostate Cancer: The Effect of Gleason Score, Dose and Heterogeneity of Intermediate Risk on Outcome Utilizing 2.2014 NCCN Risk Stratification Guidelines

Frontiers in Oncology ◽

10.3389/fonc.2014.00312 ◽

2014 ◽

Vol 4 ◽

Cited By ~ 7

Author(s):

Matthew Bernetich ◽

Caspian Oliai ◽

Rachelle Lanciano ◽

Alexandra Hanlon ◽

John Lamond ◽

...

Keyword(s):

Prostate Cancer ◽

Risk Stratification ◽

Gleason Score ◽

Primary Treatment ◽

Localized Prostate Cancer ◽

Intermediate Risk

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Comparative Effectiveness of Conservative Management Compared to Cryotherapy in Localized Prostate Cancer Patients

American Journal of Men s Health ◽

10.1177/1557988318781731 ◽

2018 ◽

Vol 12 (5) ◽

pp. 1681-1691 ◽

Cited By ~ 2

Author(s):

Surbhi Shah ◽

Henry N. Young ◽

Ewan K. Cobran

Keyword(s):

Prostate Cancer ◽

Side Effects ◽

Conservative Management ◽

Comparative Effectiveness ◽

Urinary Tract Obstruction ◽

Localized Prostate Cancer ◽

Long Term Outcomes ◽

Lower Urinary Tract Obstruction

The high frequency of treatment-related side effects for men with localized prostate cancer creates uncertainty for treatment outcomes. This study assessed the comparative effectiveness of treatment-related side effects associated with conservative management and cryotherapy in patients with localized prostate cancer. A retrospective longitudinal cohort study was conducted, using the linked data of the Surveillance, Epidemiology, and End Results and Medicare, which included patients diagnosed from 2000 through year 2013, and their Medicare claims information from 2000 through 2014. To compare the differences in baseline characteristics and treatment-related side effects between the study cohorts, χ2 tests were conducted. Multivariate logistic regression was used to assess the association between treatment selection and side effects. There were 7,998 and 3,051 patients in the conservative management and cryotherapy cohort, respectively. The likelihood of erectile dysfunction, lower urinary tract obstruction, urinary fistula, urinary incontinence, and hydronephrosis was reported to be significantly lower (53%, 35%, 69%, 65%, and 36%, respectively) in the conservative management cohort. Conservative management had a lower likelihood of treatment-related side effects compared to cryotherapy. However, further research is needed to compare other significant long-term outcomes such as costs associated with these treatment choices and quality of life.

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