Focal Ablation Reduces GU Side Effects in Prostate Cancer

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(ChemotherapyAdvisor) – Focal therapy of individual prostate cancer lesions, whether multifocal or unifocal, leads to a low rate of genitourinary side effects, according to a group of UK-based researchers of several institutions, including University College of London. The study, entitled “Focal therapy for localized unifocal and multifocal prostate cancer: a prospective development study”, was published today in the online edition of The Lancet Oncology.

The researchers in this study aimed to reduce the treatment burden caused by significant genitourinary and rectal side effects that can occur when men with localized prostate cancer have undergone radical whole-gland therapy by using selective focal ablation of unifocal and multifocal cancer lesions.

The following were the inclusion data for this study: age 45–80 years; low-risk to high-risk localized prostate cancer as indicated by prostate specific antigen [PSA] ≤15 ng/mL, Gleason score ≤4 + 3, and stage ≤T2; no previous androgen deprivation or treatment for prostate cancer; ability to safely undergo multiparametric MRI and receive general anesthetic.

After treatment, genitourinary events included, but were not limited to, dysuria in nine men (22%, 95% CI 11–38), and urinary tract infection in seven men (17%, 95% CI 7–32). “Median overall International Index of Erectile Function-15 (IIEF-15) scores were similar at baseline and at 12 months (P=0.060), as were median IIEF-15 scores for intercourse satisfaction (P=0.454), sexual desire (P=0.644), and overall satisfaction (P=0.257). Significant deteriorations between baseline and 12 months were noted for IIEF-15 erectile (P=0.042) and orgasmic function (P=0.003),” the authors wrote.

“There was an improvement in lower urinary tract symptoms, assessed by International Prostate Symptom Score (IPSS), between baseline and 12 months (P=0.026). No histological evidence of cancer was identified in 30 of 39 men biopsied at six months (77%, 95% CI 61–89); 36 (92%, 79–98) were free of clinically significant cancer. After retreatment in four men, 39 of 41 (95%, 95% CI 83–99) had no evidence of disease on multiparametric MRI at 12 months,” the authors wrote.


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