Ciência e terapia do câncer

Quality of Life and Safety Outcomes Following Irreversible Electroporation Treatment for Prostate Cancer: Results from a Phase I-II Study

Abstract

Van den Bos W, De Bruin DM, Veelo DP, Postema AW, Muller BG, Varkarakis IM, Skolarikos A, Zondervan PJ, Laguna Pes MP, Savci-Heijink CD, Wijkstra H, De Reijke TM and De La Rosette JJMCH

Objective: Prostate cancer treatment as radical prostatectomy or radiation therapy is associated with collateral tissue damage resulting inside-effects. Irreversible electroporation is a minimally invasive technique that has shown to be effective in destroying tumour cells and has been proposed to diminish the treatment related morbidity. The aim of the study was to evaluate the safety and quality of life (QoL) and functional outcomes of extended and focal irreversible electroporation (IRE) in prostate cancer.

Methods: IRE-ablations of the prostate were performed using two treatment protocols (focal and extended) to assess potential variation in outcomes. The safety of IRE was assessed by the device-related, periprocedural- and post procedural adverse events. Post-procedural quality of life was measured by prostate cancer-specific QoL questionnaires. Several validated questionnaires were used to determine the following outcomes: genitourinary side effects, urinary and erectile function. Post-procedural pain was scored using the visual analogue scale and the length of hospital stay was documented.

Results: Mainly mild adverse events (grade 1-2) occurred during the short-term follow-up, mostly concerning lower urinary tract symptoms. Nearly all resolved between the first and fourth week post treatment. Quality of life assessment showed deterioration in the urinary domain for both treatment protocols. Functional outcome questionnaire results remained stable over time. The reported post-procedural pain was low with a median of 0.5 one day post-IRE, and the length of hospital stay was short (mean of 3 days). Analysis per treatment protocol showed a significant increase between one and four weeks post treatment (p=0.03) in the extended treatment group.

Conclusion: Irreversible electroporation can be performed safely in patients suffering from prostate cancer. The adverse events are mostly temporary. Quality of life assessment shows deterioration in the urinary domain; however, functional outcomes remain stable over time.