Current state of image-guided focal therapy for prostate cancer.

Journal Article (Journal Article;Review)

PURPOSE: To review the current evidence regarding protocols and outcomes of image-guided focal therapy (FT) for prostate cancer (PCa). METHODS: A literature search of the latest published studies assessing primary FT for PCa was carried out in Medline and Cochrane library databases followed by a critical review. FT modalities, follow-up strategies, and oncological and toxicity outcomes were summarized and discussed in this review. RESULTS: Twenty-four studies with six different sources of energy met the inclusion criteria. A heterogeneity of patient selection, energy sources, treatment templates, and definitions of failure was found among the studies. While a third of patients may be found to have additional cancer burden over 3-5 years following FT, most patients will remain free of a radical procedure. The vast majority of patients maintain urinary continence and good erectile function after FT. Acute urinary retention is the most common complication, whilst severe complications remain rare. CONCLUSION: An increasing number of prospective studies with longer follow-up have been recently published. Acceptable cancer control and low treatment toxicity after FT have been consistently reported. Follow-up imaging and routine biopsy must be encouraged post-FT. While there is no reliable PSA threshold to predict failure after FT, reporting post-FT positive biopsies and retreatment rates appear to be standard when assessing treatment efficacy.

Full Text

Duke Authors

Cited Authors

  • Tourinho-Barbosa, RR; Wood, BJ; Abreu, AL; Nahar, B; Shin, T; Guven, S; Polascik, TJ

Published Date

  • March 2021

Published In

Volume / Issue

  • 39 / 3

Start / End Page

  • 701 - 717

PubMed ID

  • 32444886

Electronic International Standard Serial Number (EISSN)

  • 1433-8726

Digital Object Identifier (DOI)

  • 10.1007/s00345-020-03254-4

Language

  • eng

Conference Location

  • Germany