Focal therapy for localized prostate cancer – Current status

Abstract

Focal therapy (FT) has recently gained popularity for the treatment of localized prostate cancer (PCa). FT achieves cancer control by targeting the lesions or the regions of the cancer and avoids damage to the surrounding tissues thus minimizing side effects which are common to the radical treatment, such as urinary continence and sexual function, and bowel-related side effects. Various ablative methods are used to deliver energy to the cancerous tissue. We review the different modalities of treatment and the current state of FT for PCa.

Transperineal Laser Ablation (TPLA) Treatment of Focal Low–Intermediate Risk Prostate Cancer

“…Currently, a myriad of focal treatment modalities is available for the ablation of prostate cancer. These encompass cryotherapy, high-intensity focused ultrasound (HIFU), irreversible electroporation, photodynamic therapy, and focal brachytherapy [13].…”

“…Photodynamic therapy (PDT) shares some similarities with FLA, as it also employs transperineally inserted optical fibers directed at the prostate target. However, it is noteworthy that Azzouzi et al reported a notable rate of 38% for erectile dysfunction and urinary complications associated with PDT [13].…”

“…A study on the irreversible electroporation investigated 63 patients and reported a 16% of in-field recurrence with a mild decline in the sexual quality-of-life score [13]. Within focal brachytherapy, seeds are transperineally inserted into the prostate.…”

“…King et al conducted an evaluation of 354 patients who underwent brachytherapy focused on the peripheral zone, revealing long-term oncologic results that are concerning. Specifically, they reported a 10-year biochemical progression-free survival rate of only 28% for patients with intermediate-risk prostate cancer [13].…”