PURPOSE: To determine if stage T(1)/T(2) prostate cancer can be treated safely and effectively with interstitial thermal ablation. PATIENTS AND METHODS: Twenty patients with biopsy-confirmed prostate cancer were enrolled in the protocol. The average age was 71.0 years, and the pretreatment prostate specific antigen (PSA) concentration ranged from 2.5 to 10.7 ng/mL and the Gleason sum from 3 to 7. An array of small biocompatible magnetic alloy rods was placed in the patients percutaneously in a procedure analogous to the placement of brachytherapy seeds. Rods were placed end-to-end and no further than 1 cm apart; rods extended to the capsule and were placed at the capsule in the rectal grove. The rods are temperature self-regulating and heat to 70 degrees C when placed in an alternating magnetic field. Each patient was treated in a coil system that supplies a uniform magnetic field throughout the patient's pelvis for a single 60-minute session. Urethral cooling and rectal temperature monitoring was performed. Serial PSA was followed, and biopsy was performed 1 year post-treatment. RESULTS: Immediately after treatment, most PSA values increased dramatically but then fell to <1.0 ng/mL within 8 weeks. After 1 year, five patients had positive biopsies; these patients had significantly lower rodimplant densities. Eight patients reported erectile dysfunction, but none reported incontinence. Other complications were minor. CONCLUSION: The data suggest that this technique is well tolerated and safe and may be useful in certain patients with T(1)/T(2) prostate cancer.
PURPOSE: To determine if stage T(1)/T(2) prostate cancer can be treated safely and effectively with interstitial thermal ablation. PATIENTS AND METHODS: Twenty patients with biopsy-confirmed prostate cancer were enrolled in the protocol. The average age was 71.0 years, and the pretreatment prostate specific antigen (PSA) concentration ranged from 2.5 to 10.7 ng/mL and the Gleason sum from 3 to 7. An array of small biocompatible magnetic alloy rods was placed in the patients percutaneously in a procedure analogous to the placement of brachytherapy seeds. Rods were placed end-to-end and no further than 1 cm apart; rods extended to the capsule and were placed at the capsule in the rectal grove. The rods are temperature self-regulating and heat to 70 degrees C when placed in an alternating magnetic field. Each patient was treated in a coil system that supplies a uniform magnetic field throughout the patient's pelvis for a single 60-minute session. Urethral cooling and rectal temperature monitoring was performed. Serial PSA was followed, and biopsy was performed 1 year post-treatment. RESULTS: Immediately after treatment, most PSA values increased dramatically but then fell to <1.0 ng/mL within 8 weeks. After 1 year, five patients had positive biopsies; these patients had significantly lower rodimplant densities. Eight patients reported erectile dysfunction, but none reported incontinence. Other complications were minor. CONCLUSION: The data suggest that this technique is well tolerated and safe and may be useful in certain patients with T(1)/T(2) prostate cancer.
Authors: Freddie C Hamdy; Jenny L Donovan; J Athene Lane; Malcolm Mason; Chris Metcalfe; Peter Holding; Julia Wade; Sian Noble; Kirsty Garfield; Grace Young; Michael Davis; Tim J Peters; Emma L Turner; Richard M Martin; Jon Oxley; Mary Robinson; John Staffurth; Eleanor Walsh; Jane Blazeby; Richard Bryant; Prasad Bollina; James Catto; Andrew Doble; Alan Doherty; David Gillatt; Vincent Gnanapragasam; Owen Hughes; Roger Kockelbergh; Howard Kynaston; Alan Paul; Edgar Paez; Philip Powell; Stephen Prescott; Derek Rosario; Edward Rowe; David Neal Journal: Health Technol Assess Date: 2020-08 Impact factor: 4.014
Authors: Rebecca R Baker; Christopher Payne; Yichao Yu; Matin Mohseni; John J Connell; Fangyu Lin; Ian F Harrison; Paul Southern; Umesh S Rudrapatna; Daniel J Stuckey; Tammy L Kalber; Bernard Siow; Lewis Thorne; Shonit Punwani; Derek K Jones; Mark Emberton; Quentin A Pankhurst; Mark F Lythgoe Journal: Adv Sci (Weinh) Date: 2022-02-02 Impact factor: 17.521