Focal vs extended ablation in localized prostate cancer with irreversible electroporation; a multi-center randomized controlled trial

BMC Cancer

Study Protocol

Jean JMCH de la Rosette¹  Matthijs J. V. Scheltema¹  Theo M. de Reijke¹  Willemien van den Bos¹  M. Pilar Laguna¹  Daniel M. de Bruin²  Hessel Wijkstra³ 

[1] Department of Urology, AMC University Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands;Department of Urology, AMC University Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands;Department of Biomedical Engineering and Physics, AMC University Hospital, Amsterdam, The Netherlands;Department of Urology, AMC University Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands;Signal Processing Systems, Eindhoven University of Technology, Eindhoven, The Netherlands;

关键词: Irreversible electroporation;    IRE;    Prostate cancer;    Localized;    Focal therapy;    Ablation;    Randomized controlled trial;   

DOI  :  10.1186/s12885-016-2332-z

 received in 2016-02-23, accepted in 2016-05-01,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundCurrent surgical and ablative treatment options for prostate cancer (PCa) may result in a high incidence of (temporary) incontinence, erectile dysfunction and/or bowel damage. These side effects are due to procedure related effects on adjacent structures including blood vessels, bowel, urethra and/or neurovascular bundle. Ablation with irreversible electroporation (IRE) has shown to be effective and safe in destroying PCa cells and also has the potential advantage of sparing surrounding tissue and vital structures, resulting in less impaired functional outcomes and maintaining men’s quality of life.Methods/DesignIn this randomized controlled trial (RCT) on IRE in localized PCa, 200 patients with organ-confined, unilateral (T1c-T2b) low- to intermediate-risk PCa (Gleason sum score 6 and 7) on transperineal template-mapping biopsies (TTMB) will be included. Patients will be randomized into focal or extended ablation of cancer foci with IRE. Oncological efficacy will be determined by multiparametric Magnetic Resonance Imaging, Contrast-Enhanced Ultrasound imaging if available, TTMP and Prostate Specific Antigen (PSA) follow-up. Patients will be evaluated up to 5 years on functional outcomes and quality of life with the use of standardized questionnaires.DiscussionThere is critical need of larger, standardized RCTs evaluating long-term oncological and functional outcomes before introducing IRE and other focal therapy modalities as an accepted and safe therapeutic option for PCa. This RCT will provide important short- and long-term data and elucidates the differences between focal or extended ablation of localized, unilateral low- to intermediate-risk PCa with IRE.Trial registrationClinicaltrials.gov database registration number NCT01835977. The Dutch Central Committee on Research Involving Human Subjects registration number NL50791.018.14.

【 授权许可】

CC BY   
© Scheltema et al. 2016