Skip to main content
Erschienen in: Der Urologe 10/2017

30.08.2017 | Magnetresonanztomografie | CME

Fokale Therapie des Prostatakarzinoms

verfasst von: Prof. Dr. R. Ganzer, FEBU, T. Franiel, J. Köllermann, T. Kuru, D. Baumunk, A. Blana, B. Hadaschik, J. von Hardenberg, T. Henkel, K.-U. Köhrmann, U.-B. Liehr, S. Machtens, A. Roosen, G. Salomon, H.-P. Schlemmer, L. Sentker, J. Wendler, U. Witzsch, M. Schostak

Erschienen in: Die Urologie | Ausgabe 10/2017

Einloggen, um Zugang zu erhalten

Zusammenfassung

Ziel der fokalen Therapie (FT) des Prostatakarzinoms (PC) ist eine Teilbehandlung der Prostata unter Schonung der angrenzenden Strukturen. Dadurch sollen typische Nebenwirkungen radikaler Therapieoptionen bei gleichzeitiger Tumorkontrolle minimiert werden. Zahlreiche etablierte und neue Technologien kommen dazu zum Einsatz. Ergebnisse zahlreicher Fallserien belegen ein geringes Nebenwirkungsspektrum bei guten funktionellen Ergebnissen. Onkologische Langzeitergebnisse liegen bislang nicht vor.
Die photodynamische Therapie ist die einzige Technologie, die im Rahmen einer veröffentlichten prospektiv randomisierten Studie untersucht wurde. Die FT wird durch die Multifokalität des PC erschwert. Daher sind an die Biopsie, die pathologische Begutachtung sowie an die Bildgebung höchste Ansprüche zu stellen. Die multiparametrische Magnetresonanztomographie (mpMRT) nimmt einen wichtigen Stellenwert ein. Die FT ist experimentell und soll daher nur in Studien durchgeführt werden.
Literatur
1.
Zurück zum Zitat Wilt TJ, Brawer MK, Jones KM et al (2012) Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med 367:203–213CrossRefPubMedPubMedCentral Wilt TJ, Brawer MK, Jones KM et al (2012) Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med 367:203–213CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Bill-Axelson A, Holmberg L, Ruutu M et al (2011) Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med 364:1708–1717CrossRefPubMed Bill-Axelson A, Holmberg L, Ruutu M et al (2011) Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med 364:1708–1717CrossRefPubMed
3.
Zurück zum Zitat Tan HJ, Marks LS, Hoyt MA et al (2016) The relationship between intolerance of uncertainty and anxiety in men on active surveillance for prostate cancer. J Urol 195:1724–1730CrossRefPubMedPubMedCentral Tan HJ, Marks LS, Hoyt MA et al (2016) The relationship between intolerance of uncertainty and anxiety in men on active surveillance for prostate cancer. J Urol 195:1724–1730CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat D’amico AV, Whittington R, Malkowicz SB et al (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969–974CrossRefPubMed D’amico AV, Whittington R, Malkowicz SB et al (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969–974CrossRefPubMed
5.
Zurück zum Zitat Carroll PR, Parsons JK, Andriole G et al (2016) NCCN Guidelines Insights: Prostate Cancer Early Detection, Version 2.2016. J Natl Compr Canc Netw 14:509–519CrossRefPubMed Carroll PR, Parsons JK, Andriole G et al (2016) NCCN Guidelines Insights: Prostate Cancer Early Detection, Version 2.2016. J Natl Compr Canc Netw 14:509–519CrossRefPubMed
6.
Zurück zum Zitat Noguchi M, Stamey TA, Mcneal JE et al (2003) Prognostic factors for multifocal prostate cancer in radical prostatectomy specimens: lack of significance of secondary cancers. J Urol 170:459–463CrossRefPubMed Noguchi M, Stamey TA, Mcneal JE et al (2003) Prognostic factors for multifocal prostate cancer in radical prostatectomy specimens: lack of significance of secondary cancers. J Urol 170:459–463CrossRefPubMed
7.
Zurück zum Zitat Mcneal JE (1992) Cancer volume and site of origin of adenocarcinoma in the prostate: relationship to local and distant spread. Hum Pathol 23:258–266CrossRefPubMed Mcneal JE (1992) Cancer volume and site of origin of adenocarcinoma in the prostate: relationship to local and distant spread. Hum Pathol 23:258–266CrossRefPubMed
8.
Zurück zum Zitat Huang CC, Deng FM, Kong MX et al (2014) Re-evaluating the concept of “dominant/index tumor nodule” in multifocal prostate cancer. Virchows Arch 464:589–594CrossRefPubMed Huang CC, Deng FM, Kong MX et al (2014) Re-evaluating the concept of “dominant/index tumor nodule” in multifocal prostate cancer. Virchows Arch 464:589–594CrossRefPubMed
9.
Zurück zum Zitat Isbarn H, Karakiewicz PI, Vogel S et al (2010) Unilateral prostate cancer cannot be accurately predicted in low-risk patients. Int J Radiat Oncol Biol Phys 77:784–787CrossRefPubMed Isbarn H, Karakiewicz PI, Vogel S et al (2010) Unilateral prostate cancer cannot be accurately predicted in low-risk patients. Int J Radiat Oncol Biol Phys 77:784–787CrossRefPubMed
10.
Zurück zum Zitat Onik G, Miessau M, Bostwick DG (2009) Three-dimensional prostate mapping biopsy has a potentially significant impact on prostate cancer management. J Clin Oncol 27:4321–4326CrossRefPubMed Onik G, Miessau M, Bostwick DG (2009) Three-dimensional prostate mapping biopsy has a potentially significant impact on prostate cancer management. J Clin Oncol 27:4321–4326CrossRefPubMed
11.
Zurück zum Zitat Franiel T, Asbach P, Teichgraber U et al (2015) Prostate imaging – an update. Rofo 187:751–759CrossRefPubMed Franiel T, Asbach P, Teichgraber U et al (2015) Prostate imaging – an update. Rofo 187:751–759CrossRefPubMed
12.
Zurück zum Zitat Franiel T, Hamm B, Hricak H (2011) Dynamic contrast-enhanced magnetic resonance imaging and pharmacokinetic models in prostate cancer. Eur Radiol 21:616–626CrossRefPubMed Franiel T, Hamm B, Hricak H (2011) Dynamic contrast-enhanced magnetic resonance imaging and pharmacokinetic models in prostate cancer. Eur Radiol 21:616–626CrossRefPubMed
13.
Zurück zum Zitat Kasel-Seibert M, Lehmann T, Aschenbach R et al (2016) Assessment of PI-RADS v2 for the detection of prostate cancer. Eur J Radiol 85:726–731CrossRefPubMed Kasel-Seibert M, Lehmann T, Aschenbach R et al (2016) Assessment of PI-RADS v2 for the detection of prostate cancer. Eur J Radiol 85:726–731CrossRefPubMed
14.
Zurück zum Zitat Ahmed HU, El-Shater Bosaily A, Brown LC et al (2017) Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 389:815–822CrossRefPubMed Ahmed HU, El-Shater Bosaily A, Brown LC et al (2017) Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 389:815–822CrossRefPubMed
15.
Zurück zum Zitat Donaldson IA, Alonzi R, Barratt D et al (2015) Focal therapy: patients, interventions, and outcomes – a report from a consensus meeting. Eur Urol 67:771–777CrossRefPubMedPubMedCentral Donaldson IA, Alonzi R, Barratt D et al (2015) Focal therapy: patients, interventions, and outcomes – a report from a consensus meeting. Eur Urol 67:771–777CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Van Den Bos W, Muller BG, Ahmed H et al (2014) Focal therapy in prostate cancer: international multidisciplinary consensus on trial design. Eur Urol 65:1078–1083CrossRefPubMed Van Den Bos W, Muller BG, Ahmed H et al (2014) Focal therapy in prostate cancer: international multidisciplinary consensus on trial design. Eur Urol 65:1078–1083CrossRefPubMed
17.
Zurück zum Zitat Eggener SE, Scardino PT, Carroll PR et al (2007) Focal therapy for localized prostate cancer: a critical appraisal of rationale and modalities. J Urol 178:2260–2267PubMed Eggener SE, Scardino PT, Carroll PR et al (2007) Focal therapy for localized prostate cancer: a critical appraisal of rationale and modalities. J Urol 178:2260–2267PubMed
18.
Zurück zum Zitat De La Rosette J, Ahmed H, Barentsz J et al (2010) Focal therapy in prostate cancer-report from a consensus panel. J Endourol/Endourol Soc 24:775–780 De La Rosette J, Ahmed H, Barentsz J et al (2010) Focal therapy in prostate cancer-report from a consensus panel. J Endourol/Endourol Soc 24:775–780
19.
Zurück zum Zitat Van Den Bos W, De Bruin DM, Muller BG et al (2014) The safety and efficacy of irreversible electroporation for the ablation of prostate cancer: a multicentre prospective human in vivo pilot study protocol. BMJ Open 4:e006382CrossRefPubMedPubMedCentral Van Den Bos W, De Bruin DM, Muller BG et al (2014) The safety and efficacy of irreversible electroporation for the ablation of prostate cancer: a multicentre prospective human in vivo pilot study protocol. BMJ Open 4:e006382CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Donaldson IA, Alonzi R, Barratt D et al (2015) Focal therapy: patients, interventions, and outcomes – a report from a consensus meeting. Eur Urol 67:771–777CrossRefPubMedPubMedCentral Donaldson IA, Alonzi R, Barratt D et al (2015) Focal therapy: patients, interventions, and outcomes – a report from a consensus meeting. Eur Urol 67:771–777CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Priester A, Natarajan S, Khoshnoodi P et al (2017) Magnetic resonance imaging underestimation of prostate cancer geometry: use of patient specific molds to correlate images with whole mount pathology. J Urol 197:320–326CrossRefPubMed Priester A, Natarajan S, Khoshnoodi P et al (2017) Magnetic resonance imaging underestimation of prostate cancer geometry: use of patient specific molds to correlate images with whole mount pathology. J Urol 197:320–326CrossRefPubMed
23.
Zurück zum Zitat Azzouzi AR, Vincendeau S, Barret E et al (2017) Padeliporfin vascular-targeted photodynamic therapy versus active surveillance in men with low-risk prostate cancer (CLIN1001 PCM301): an open-label, phase 3, randomised controlled trial. Lancet Oncol 18:181–191CrossRefPubMed Azzouzi AR, Vincendeau S, Barret E et al (2017) Padeliporfin vascular-targeted photodynamic therapy versus active surveillance in men with low-risk prostate cancer (CLIN1001 PCM301): an open-label, phase 3, randomised controlled trial. Lancet Oncol 18:181–191CrossRefPubMed
24.
Zurück zum Zitat Bahn D, De Castro Abreu AL, Gill IS et al (2012) Focal cryotherapy for clinically unilateral, low-intermediate risk prostate cancer in 73 men with a median follow-up of 3.7 years. Eur Urol 62:55–63CrossRefPubMed Bahn D, De Castro Abreu AL, Gill IS et al (2012) Focal cryotherapy for clinically unilateral, low-intermediate risk prostate cancer in 73 men with a median follow-up of 3.7 years. Eur Urol 62:55–63CrossRefPubMed
25.
Zurück zum Zitat El Fegoun AB, Barret E, Prapotnich D et al (2011) Focal therapy with high-intensity focused ultrasound for prostate cancer in the elderly. A feasibility study with 10 years follow-up. Int Braz J Urol 37:213–219 (discussion 220–212)CrossRefPubMed El Fegoun AB, Barret E, Prapotnich D et al (2011) Focal therapy with high-intensity focused ultrasound for prostate cancer in the elderly. A feasibility study with 10 years follow-up. Int Braz J Urol 37:213–219 (discussion 220–212)CrossRefPubMed
26.
Zurück zum Zitat Feijoo ER, Sivaraman A, Barret E et al (2016) Focal high-intensity focused ultrasound targeted Hemiablation for unilateral prostate cancer: a prospective evaluation of oncologic and functional outcomes. Eur Urol 69:214–220CrossRefPubMed Feijoo ER, Sivaraman A, Barret E et al (2016) Focal high-intensity focused ultrasound targeted Hemiablation for unilateral prostate cancer: a prospective evaluation of oncologic and functional outcomes. Eur Urol 69:214–220CrossRefPubMed
27.
Zurück zum Zitat Lindner U, Weersink RA, Haider MA et al (2009) Image guided photothermal focal therapy for localized prostate cancer: phase I trial. J Urol 182:1371–1377CrossRefPubMed Lindner U, Weersink RA, Haider MA et al (2009) Image guided photothermal focal therapy for localized prostate cancer: phase I trial. J Urol 182:1371–1377CrossRefPubMed
28.
Zurück zum Zitat Onik G, Vaughan D, Lotenfoe R et al (2007) “Male lumpectomy”: focal therapy for prostate cancer using cryoablation. Urology 70:16–21CrossRefPubMed Onik G, Vaughan D, Lotenfoe R et al (2007) “Male lumpectomy”: focal therapy for prostate cancer using cryoablation. Urology 70:16–21CrossRefPubMed
29.
Zurück zum Zitat Oto A, Sethi I, Karczmar G et al (2013) MR imaging-guided focal laser ablation for prostate cancer: phase I trial. Radiology 267:932–940CrossRefPubMed Oto A, Sethi I, Karczmar G et al (2013) MR imaging-guided focal laser ablation for prostate cancer: phase I trial. Radiology 267:932–940CrossRefPubMed
30.
Zurück zum Zitat Van Velthoven R, Aoun F, Marcelis Q et al (2016) A prospective clinical trial of HIFU hemiablation for clinically localized prostate cancer. Prostate Cancer Prostatic Dis 19:79–83CrossRefPubMed Van Velthoven R, Aoun F, Marcelis Q et al (2016) A prospective clinical trial of HIFU hemiablation for clinically localized prostate cancer. Prostate Cancer Prostatic Dis 19:79–83CrossRefPubMed
31.
Zurück zum Zitat Chin JL, Billia M, Relle J et al (2016) Magnetic resonance imaging-guided Transurethral ultrasound ablation of prostate tissue in patients with localized prostate cancer: a prospective phase 1 clinical trial. Eur Urol 70:447–455CrossRefPubMed Chin JL, Billia M, Relle J et al (2016) Magnetic resonance imaging-guided Transurethral ultrasound ablation of prostate tissue in patients with localized prostate cancer: a prospective phase 1 clinical trial. Eur Urol 70:447–455CrossRefPubMed
32.
Zurück zum Zitat Valerio M, Dickinson L, Ali A et al (2017) Nanoknife electroporation ablation trial: a prospective development study investigating focal irreversible electroporation for localized prostate cancer. J Urol 197:647–654CrossRefPubMed Valerio M, Dickinson L, Ali A et al (2017) Nanoknife electroporation ablation trial: a prospective development study investigating focal irreversible electroporation for localized prostate cancer. J Urol 197:647–654CrossRefPubMed
33.
Zurück zum Zitat Ward JF, Jones JS (2012) Focal cryotherapy for localized prostate cancer: a report from the national Cryo On-Line Database (COLD) registry. BJU Int 109:1648–1654CrossRefPubMed Ward JF, Jones JS (2012) Focal cryotherapy for localized prostate cancer: a report from the national Cryo On-Line Database (COLD) registry. BJU Int 109:1648–1654CrossRefPubMed
34.
Zurück zum Zitat Rischmann P, Gelet A, Riche B et al (2017) Focal High intensity focused ultrasound of unilateral localized prostate cancer: a prospective multicentric hemiablation study of 111 patients. Eur Urol 71:267–273CrossRefPubMed Rischmann P, Gelet A, Riche B et al (2017) Focal High intensity focused ultrasound of unilateral localized prostate cancer: a prospective multicentric hemiablation study of 111 patients. Eur Urol 71:267–273CrossRefPubMed
35.
Zurück zum Zitat Azzouzi AR, Vincendeau S, Barret E et al (2017) Padeliporfin vascular-targeted photodynamic therapy versus active surveillance in men with low-risk prostate cancer (CLIN1001 PCM301): an open-label, phase 3, randomised controlled trial. Lancet Oncol 18:181–191CrossRefPubMed Azzouzi AR, Vincendeau S, Barret E et al (2017) Padeliporfin vascular-targeted photodynamic therapy versus active surveillance in men with low-risk prostate cancer (CLIN1001 PCM301): an open-label, phase 3, randomised controlled trial. Lancet Oncol 18:181–191CrossRefPubMed
36.
Zurück zum Zitat Valerio M, Dickinson L, Ali A et al (2017) Nanoknife electroporation ablation trial: a prospective development study investigating focal irreversible electroporation for localized prostate cancer. J Urol 197:647–654PubMed Valerio M, Dickinson L, Ali A et al (2017) Nanoknife electroporation ablation trial: a prospective development study investigating focal irreversible electroporation for localized prostate cancer. J Urol 197:647–654PubMed
38.
Zurück zum Zitat Valerio M, Ahmed HU, Emberton M et al (2014) The role of focal therapy in the management of localised prostate cancer: a systematic review. Eur Urol 66:732–751CrossRefPubMedPubMedCentral Valerio M, Ahmed HU, Emberton M et al (2014) The role of focal therapy in the management of localised prostate cancer: a systematic review. Eur Urol 66:732–751CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Edd JF, Horowitz L, Davalos RV et al (2006) In vivo results of a new focal tissue ablation technique: irreversible electroporation. IEEE Trans Biomed Eng 53:1409–1415CrossRefPubMed Edd JF, Horowitz L, Davalos RV et al (2006) In vivo results of a new focal tissue ablation technique: irreversible electroporation. IEEE Trans Biomed Eng 53:1409–1415CrossRefPubMed
40.
Zurück zum Zitat Van Den Bos W, De Bruin DM, Muller BG et al (2014) The safety and efficacy of irreversible electroporation for the ablation of prostate cancer: a multicentre prospective human in vivo pilot study protocol. BMJ Open 4:e6382CrossRefPubMedPubMedCentral Van Den Bos W, De Bruin DM, Muller BG et al (2014) The safety and efficacy of irreversible electroporation for the ablation of prostate cancer: a multicentre prospective human in vivo pilot study protocol. BMJ Open 4:e6382CrossRefPubMedPubMedCentral
41.
Zurück zum Zitat Ting F, Tran M, Bohm M et al (2016) Focal irreversible electroporation for prostate cancer: functional outcomes and short-term oncological control. Prostate Cancer Prostatic Dis 19:46–52CrossRefPubMed Ting F, Tran M, Bohm M et al (2016) Focal irreversible electroporation for prostate cancer: functional outcomes and short-term oncological control. Prostate Cancer Prostatic Dis 19:46–52CrossRefPubMed
42.
Zurück zum Zitat Valerio M, Stricker PD, Ahmed HU et al (2014) Initial assessment of safety and clinical feasibility of irreversible electroporation in the focal treatment of prostate cancer. Prostate Cancer Prostatic Dis 17:343–347CrossRefPubMedPubMedCentral Valerio M, Stricker PD, Ahmed HU et al (2014) Initial assessment of safety and clinical feasibility of irreversible electroporation in the focal treatment of prostate cancer. Prostate Cancer Prostatic Dis 17:343–347CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Van Den Bos W, Scheffer HJ, Vogel JA et al (2016) Thermal energy during irreversible electroporation and the influence of different ablation parameters. J Vasc Interv Radiol 27:433–443CrossRefPubMed Van Den Bos W, Scheffer HJ, Vogel JA et al (2016) Thermal energy during irreversible electroporation and the influence of different ablation parameters. J Vasc Interv Radiol 27:433–443CrossRefPubMed
Metadaten
Titel
Fokale Therapie des Prostatakarzinoms
verfasst von
Prof. Dr. R. Ganzer, FEBU
T. Franiel
J. Köllermann
T. Kuru
D. Baumunk
A. Blana
B. Hadaschik
J. von Hardenberg
T. Henkel
K.-U. Köhrmann
U.-B. Liehr
S. Machtens
A. Roosen
G. Salomon
H.-P. Schlemmer
L. Sentker
J. Wendler
U. Witzsch
M. Schostak
Publikationsdatum
30.08.2017
Verlag
Springer Medizin
Erschienen in
Die Urologie / Ausgabe 10/2017
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI
https://doi.org/10.1007/s00120-017-0488-z

Weitere Artikel der Ausgabe 10/2017

Der Urologe 10/2017 Zur Ausgabe

BDU-Journal – Berufspolitik

BDU-Journal – Berufspolitik

Termine

Termine