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The results of the phase 1 clinical trials revealed that focal laser ablation was successful in all 8 subjects. This is because 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 post treatment magnetic resonance imaging, had a median volume of 3 cc or 7.7% of prostate volume. The quality of life questionnaires (I-PSS and SHIM) showed no statistically significant changes in either metric was observed after 6 months (p>0.05). Prostate specific antigen decreased in 7 men (p<0.01).
In conclusion, the investigators determined that focal laser ablation of the prostate is safe procedure done in men with intermediate risk prostate cancer. This is because there are no series adverse events or significant changes in urinary or sexual functions at 6 months. The comprehensive biopsy follow-up indicates that larger treatment margins than previously thought necessary may be required for complete tumor ablation. Future studies are needed to establish FLA as an acceptable treatment alternative, such as its long-term efficacy, which patients may be the best candidates, and patient satisfaction. Overall, the results of this paper justifies further research for FLA, and hopefully translating it into a conventional clinically procedure in the future.
Authors: 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†
Affiliations: Department of Urology (SN, PL, MLM, LSM), Department of Bioengineering (SN, AMP, JG, WG), Center for Advanced Surgical and Interventional Technology (SN, AMP, JG, WG, LSM), Department of Radiology (SR, DJAM) and Department of Pathology (JH), University of California, Los Angeles, Los Angeles, California
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Lindner U, Weersink R, Haider M et al: Image guided photothermal focal therapy for localized prostate cancer: phase I trial. J Urol 2009; 182: 1371.
McNichols R, Kangasniemi M, Gowda A et al: Technical developments for cerebral thermal treatment: water-cooled diffusing laser fibre tips and temperature-sensitive MRI using intersecting image planes. Int J Hyperthermia 2004; 20: 45.