scholarly journals The safety and efficacy of irreversible electroporation for the ablation of prostate cancer: a multicentre prospective human in vivo pilot study protocol

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e006382 ◽  
Author(s):  
W van den Bos ◽  
D M de Bruin ◽  
B G Muller ◽  
I M Varkarakis ◽  
A A Karagiannis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Pilot Study ◽  
Side Effects ◽  
Radical Prostatectomy ◽  
Academic Medical Center ◽  
Irreversible Electroporation ◽  
Surrounding Tissue ◽  
Safety And Efficacy

IntroductionCurrent surgical and ablative treatment options for prostate cancer have a relatively high incidence of side effects, which may diminish the quality of life. The side effects are a consequence of procedure-related damage of the blood vessels, bowel, urethra or neurovascular bundle. Ablation with irreversible electroporation (IRE) has shown to be effective in destroying tumour cells and harbours the advantage of sparing surrounding tissue and vital structures. The aim of the study is to evaluate the safety and efficacy and to acquire data on patient experience of minimally invasive, transperineally image-guided IRE for the focal ablation of prostate cancer.Methods and analysisIn this multicentre pilot study, 16 patients with prostate cancer who are scheduled for a radical prostatectomy will undergo an IRE procedure, approximately 30 days prior to the radical prostatectomy. Data as adverse events, side effects, functional outcomes, pain and quality of life will be collected and patients will be controlled at 1 and 2 weeks post-IRE, 1 day preprostatectomy and postprostatectomy. Prior to the IRE procedure and the radical prostatectomy, all patients will undergo a multiparametric MRI and contrast-enhanced ultrasound of the prostate. The efficacy of ablation will be determined by whole mount histopathological examination, which will be correlated with the imaging of the ablation zone.Ethics and disseminationThe protocol is approved by the ethics committee at the coordinating centre (Academic Medical Center (AMC) Amsterdam) and by the local Institutional Review Board at the participating centres. Data will be presented at international conferences and published in peer-reviewed journals.ConclusionsThis pilot study will determine the safety and efficacy of IRE in the prostate. It will show the radiological and histopathological effects of IRE ablations and it will provide data to construct an accurate treatment planning tool for IRE in prostate tissue.Trial registration numberClinicaltrials.gov database: NCT01790451.

Treatment of Aggressive Behavior in Dementia With the Anticonvulsant Topiramate: A Retrospective Pilot Study

2003 ◽  
Vol 15 (3) ◽  
pp. 307-309 ◽  
Author(s):  
Benny Fhager ◽  
Inga-Maj Meiri ◽  
Magnus Sjögren ◽  
Åke Edman
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Side Effects ◽  
Aggressive Behavior ◽  
Extrapyramidal Side Effects ◽  
Treatment Resistant ◽  
Careful Treatment ◽  
And Training ◽  
Low Dosage

Aggressive behavior in dementia often has a severe impact on the quality of life of the patient and the caregivers, and is therefore important to handle. The strategy of treatment should be broad. Nonpharmacological interventions, including environmental adjustments and supporting and training the caregivers, should always be considered. Pharmacological treatment of aggressive behavior in patients with dementia often includes the use of neuroleptics. The atypical compounds clozapine, risperidone, and olanzapine have been shown to have an effect on aggressive behavior at low dosage with limited extrapyramidal side effects. The anticonvulsants carbamazepine and sodium valproate are further alternatives. In treatment-resistant cases, buspirone or lithium may be tried, although the effect of these substances on aggressive behavior in dementia has not been well established. In the end, however, a considerable degree of aggressive behavior sometimes remains after careful treatment trials, particularly in patients with severe aggressive behavior. In addition, treatment is sometimes limited by side effects.

Late urinary morbidity and quality of life after radical prostatectomy and salvage radiotherapy for prostate cancer

2017 ◽  
Vol 51 (6) ◽  
pp. 457-463 ◽  
Author(s):  
Maria Ervandian ◽  
Morten Høyer ◽  
Stine Elleberg Petersen ◽  
Lisa Sengeløv ◽  
Steinbjørn Hansen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Salvage Radiotherapy ◽  
Urinary Morbidity

scholarly journals Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with de-novo Oligometastatic Prostate Cancer

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5636
Author(s):  
Michael Chaloupka ◽  
Lina Stoermer ◽  
Maria Apfelbeck ◽  
Alexander Buchner ◽  
Vera Wenter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
De Novo ◽  
Health Related Quality ◽  
Significant Difference ◽  
Related Quality ◽  
Health Related

(1) Background: local treatment of the primary tumor has become a valid therapeutic option in de-novo oligo-metastatic prostate cancer (PC). However, evidence regarding radical prostatectomy (RP) in this setting is still subpar, and the effect of cytoreductive RP on postoperative health-related quality of life (HRQOL) is still unclear. (2) Methods: for the current study, patients with de-novo oligo-metastatic PC (cM1-oligo), defined as ≤5 bone lesions in the preoperative staging, were included, and matched cohorts using the variables age, body-mass index (BMI), and pT-stage were generated. Patient-reported outcome measures (PROMS) were assessed pre- and postoperatively using the validated EORTC-QLQ-C30, IIEF-5, and ICIQ-SF questionnaires. The primary endpoint for univariate and multivariable analysis was good general HRQOL defined by previously validated cut-off values. (3) Results: in total, 1268 patients (n = 84 (7%) cM1-oligo) underwent RP between 2012 and 2020 at one tertiary care center. A matched cohort of 411 patients (n = 79 with oligo-metastatic bone disease (cM1-oligo) and n = 332 patients without clinical indication of metastatic disease (cM0)) was created. The median follow-up was 25mo. There was no significant difference in good general HRQOL rates between cM1-oligo-patients and cM0-patients before RP (45.6% vs. 55.2%, p = 0.186), and at time of follow-up (44% vs. 56%, p = 0.811). Global health status (GHS) worsened significantly in cM0-patients compared to baseline (−5, p = 0.001), whereas GHS did not change significantly in cM1-oligo-patients (+3.2, p = 0.381). In multivariate analysis stratified for good erectile function (IIEF5 > 18; OR 5.722, 95% CI 1.89–17.36, p = 0.002) and continence recovery (OR 1.671, 95% CI 1.03–2.70, p = 0.036), cM1-oligo was not an independent predictive feature for general HRQOL (OR 0.821, 95% CI 0.44–1.53, p = 0.536). (4) Conclusions: in this large contemporary retrospective analysis, we observed no significant difference in HRQOL in patients with the oligometastatic bone disease after cytoreductive radical prostatectomy, when compared to patients with localized disease at time of surgery.

Quality of Life Following Management of Localized Prostate Cancer

2018 ◽  
Author(s):  
Louis A Aliperti ◽  
Martin G Sanda ◽  
Christopher P Filson
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Expectant Management ◽  
Diagnosis And Treatment ◽  
Urinary Tract Symptoms ◽  
Related Quality ◽  
Health Related ◽  
The Impact

With a long survivorship phase after diagnosis and treatment of prostate cancer, consideration of the impact of treatment on health-related quality of life (HRQOL) is critical. For men considering treatment of prostate cancer, the domains that are impacted include urinary, sexual, and bowel-related qualities of life. This review identifies aspects of tools measuring HRQOL and covers instruments used to measure quality of life following a diagnosis and treatment of prostate cancer. We review the impact associated with radical prostatectomy, radiation and brachytherapy, and observation on men diagnosed with prostate cancer and compare the effects that each management strategy has on sexual and urinary function. This review contains 3 figures, 5 tables, 44 references. Key Words: erectile dysfunction, expectant management, lower urinary tract symptoms, prostate cancer, radical prostatectomy, radiation therapy, quality of life, urinary incontinence

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