Background: Prostate cancer (PCa) is one of the most prevalent cancers in the world. Standard methods of screening and diagnosis for prostate cancer have been effective but can result in overtreatment of indolent prostate cancer, leading to increased morbidity. Multiparametric magnetic resonance imaging (MRI) and fusion biopsy are effective tools to achieve better diagnostic accuracy. A combination of multiparametric MRI and photodynamic therapy can be used as an alternative to active surveillance in low-risk prostate cancer to better detect disease progression while avoiding overtreatment. Methods: We conducted a retrospective multicenter study on 13 patients with low-risk prostate cancer who underwent vascular-targeted photodynamic therapy. The patients were evaluated for up to 15 months after the procedure using biochemical parameters like serum Prostate Specific Antigen (PSA), digital rectal examination, multiparametric MRI, and functional parameters like the International Prostate Symptom Score (IPSS), the 15-question International Index of Erectile Function questionnaire (IIEF-5), quality of life score (QoL), the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and a uroflowmetry examination. Results: The patients did not experience any significant complications during or after the treatment. A decrease in serum PSA and prostate volume was observed from 7.38 ng/mL to 3.8 ng/ml with functional improvement evidenced by a decrease in the IPSS (from 15.4 to 11), QoL (from 3.15 to 2), and the IIEF-5 (from 17.23 to 16) score, and an improvement in uroflowmetry. Conclusion: Vascular-targeted photodynamic therapy is a safe and effective alternative to active surveillance in patients with low-risk prostate cancer.
背景：前列腺癌是全球最常见的恶性肿瘤之一。传统筛查与诊断方法虽有效，但可能导致惰性前列腺癌的过度治疗，从而增加患者发病率。多参数磁共振成像与融合穿刺活检技术能显著提升诊断准确性。对于低危前列腺癌患者，联合应用多参数磁共振成像与光动力疗法可作为主动监测的替代方案，在避免过度治疗的同时更精准监测疾病进展。 方法：本研究对13例接受血管靶向光动力治疗的低危前列腺癌患者开展多中心回顾性分析。术后通过血清前列腺特异性抗原、直肠指诊、多参数磁共振成像等生化指标，以及国际前列腺症状评分、国际勃起功能指数问卷、生活质量评分、国际尿失禁咨询委员会简表、尿流率检测等功能指标，对患者进行长达15个月的随访评估。 结果：治疗期间及术后均未出现显著并发症。患者血清前列腺特异性抗原从7.38 ng/mL降至3.8 ng/mL，前列腺体积缩小，功能指标改善表现为：国际前列腺症状评分从15.4降至11，生活质量评分从3.15降至2，国际勃起功能指数问卷评分从17.23微调至16，同时尿流率检测显示功能提升。 结论：血管靶向光动力疗法可作为低危前列腺癌患者主动监测的安全有效替代方案。
The Safety and Efficacy of Vascular-Targeted Photodynamic Therapy in Low-Risk Prostate Cancer
肿瘤(癌症)患者之家