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Focal Laser Ablation of Prostate Cancer: Phase I Clinical Trial

2016; Lippincott Williams & Wilkins; Volume: 196; Issue: 1 Linguagem: Inglês

10.1016/j.juro.2015.12.083

1527-3792

Shyam Natarajan, Steven S. Raman, Alan Priester, James Garritano, Daniel Margolis, Patricia Lieu, Maria Luz Macairan, Jiaoti Huang, Warren Grundfest, Leonard S. Marks,

Laser-induced spectroscopy and plasma

No AccessJournal of UrologyAdult Urology1 Jul 2016Focal Laser Ablation of Prostate Cancer: Phase I Clinical Trial Shyam Natarajan, Steven Raman, Alan M. Priester, James Garritano, Daniel J.A. Margolis, Patricia Lieu, Maria L. Macairan, Jiaoti Huang, Warren Grundfest, and Leonard S. Marks Shyam NatarajanShyam Natarajan Department of Urology, University of California, Los Angeles, Los Angeles, California Department of Bioengineering, University of California, Los Angeles, Los Angeles, California Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California , Steven RamanSteven Raman Department of Radiology, University of California, Los Angeles, Los Angeles, California , Alan M. PriesterAlan M. Priester Department of Bioengineering, University of California, Los Angeles, Los Angeles, California Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California , James GarritanoJames Garritano Department of Bioengineering, University of California, Los Angeles, Los Angeles, California Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California , Daniel J.A. MargolisDaniel J.A. Margolis Department of Radiology, University of California, Los Angeles, Los Angeles, California , Patricia LieuPatricia Lieu Department of Urology, University of California, Los Angeles, Los Angeles, California , Maria L. MacairanMaria L. Macairan Department of Urology, University of California, Los Angeles, Los Angeles, California , Jiaoti HuangJiaoti Huang Department of Pathology, University of California, Los Angeles, Los Angeles, California , Warren GrundfestWarren Grundfest Department of Bioengineering, University of California, Los Angeles, Los Angeles, California Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California , and Leonard S. MarksLeonard S. Marks Department of Urology, University of California, Los Angeles, Los Angeles, California Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California View All Author Informationhttps://doi.org/10.1016/j.juro.2015.12.083AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Focal laser ablation is an investigational technique to treat prostate cancer in a region confined manner via coagulative necrosis. This phase I trial primarily examines the safety of transrectal magnetic resonance imaging guided (in-bore) focal laser ablation in men with intermediate risk prostate cancer. An exploratory end point is cancer control after 6 months. Materials and Methods: In an institutional review board approved trial we studied focal laser ablation in 8 men with intermediate risk prostate cancer diagnosed using magnetic resonance-ultrasound fusion. Focal laser ablation was performed by inserting a cylindrically diffusing, water cooled laser fiber into magnetic resonance visible regions of interest, followed by interstitial heating at 10 to 15 W for up to 3 minutes. Secondary safety monitors (thermal probes) were inserted to assess the accuracy of magnetic resonance thermometry. Comprehensive magnetic resonance-ultrasound fusion biopsy was performed after 6 months. Adverse events and health related quality of life questionnaires were recorded. Results: Focal laser ablation was successfully performed in all 8 subjects. No grade 3 or greater adverse events occurred and no changes in International Prostate Symptom Score or International Index of Erectile Function 5 were observed. Ablation zones, as measured by posttreatment magnetic resonance imaging, had a median volume of 3 cc or 7.7% of prostate volume. Prostate specific antigen decreased in 7 men (p <0.01). At followup magnetic resonance-ultrasound fusion biopsy cancer was not detected in the ablation zone in 5 men but was present outside the treatment margin in 6 men. Conclusions: Focal laser ablation of the prostate is feasible and safe in men with intermediate risk prostate cancer without serious adverse events or changes in urinary or sexual function at 6 months. Comprehensive biopsy followup indicates that larger treatment margins than previously thought necessary may be required for complete tumor ablation. References 1 : Focal therapy for localized prostate cancer: a phase I/II trial. J Urol2011; 185: 1246. 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Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byOrczyk C, Barratt D, Brew-Graves C, Peng Hu Y, Freeman A, McCartan N, Potyka I, Ramachandran N, Rodell R, Williams N, Emberton M and Ahmed H (2020) Prostate Radiofrequency Focal Ablation (ProRAFT) Trial: A Prospective Development Study Evaluating a Bipolar Radiofrequency Device to Treat Prostate CancerJournal of Urology, VOL. 205, NO. 4, (1090-1099), Online publication date: 1-Apr-2021.Natarajan S, Jones T, Priester A, Geoghegan R, Lieu P, Delfin M, Felker E, Margolis D, Sisk A, Pantuck A, Grundfest W and Marks L (2017) Focal Laser Ablation of Prostate Cancer: Feasibility of Magnetic Resonance Imaging-Ultrasound Fusion for GuidanceJournal of Urology, VOL. 198, NO. 4, (839-847), Online publication date: 1-Oct-2017.Eggener S, Yousuf A, Watson S, Wang S and Oto A (2016) Phase II Evaluation of Magnetic Resonance Imaging Guided Focal Laser Ablation of Prostate CancerJournal of Urology, VOL. 196, NO. 6, (1670-1675), Online publication date: 1-Dec-2016.Smith J (2016) This Month in Adult UrologyJournal of Urology, VOL. 196, NO. 1, (1-2), Online publication date: 1-Jul-2016. Volume 196Issue 1July 2016Page: 68-75Supplementary Materials Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordslaser therapymultimodal imagingprostatic neoplasmsablation techniquesMetricsAuthor Information Shyam Natarajan Department of Urology, University of California, Los Angeles, Los Angeles, California Department of Bioengineering, University of California, Los Angeles, Los Angeles, California Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California More articles by this author Steven Raman Department of Radiology, University of California, Los Angeles, Los Angeles, California More articles by this author Alan M. Priester Department of Bioengineering, University of California, Los Angeles, Los Angeles, California Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California More articles by this author James Garritano Department of Bioengineering, University of California, Los Angeles, Los Angeles, California Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California More articles by this author Daniel J.A. Margolis Department of Radiology, University of California, Los Angeles, Los Angeles, California Financial interest and/or other relationship with Eigen, Inc. More articles by this author Patricia Lieu Department of Urology, University of California, Los Angeles, Los Angeles, California More articles by this author Maria L. Macairan Department of Urology, University of California, Los Angeles, Los Angeles, California More articles by this author Jiaoti Huang Department of Pathology, University of California, Los Angeles, Los Angeles, California More articles by this author Warren Grundfest Department of Bioengineering, University of California, Los Angeles, Los Angeles, California Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California More articles by this author Leonard S. Marks Department of Urology, University of California, Los Angeles, Los Angeles, California Center for Advanced Surgical and Interventional Technology, University of California, Los Angeles, Los Angeles, California More articles by this author Expand All Advertisement PDF downloadLoading ...