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不可逆电穿孔用于前列腺癌的局部治疗:一项系统综述。

Irreversible Electroporation for the Focal Treatment of Prostate Cancer: A Systematic Review.

作者信息

Zhang Kai, Teoh Jeremy, Zhu Gang, Ng Chi-Fai, Suberville Michel, Laguna Pilar, de la Rosette Jean

机构信息

Department of Urology, Beijing United Family Hospital and Clinics, Beijing, China.

S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.

出版信息

World J Mens Health. 2025 Apr;43(2):321-332. doi: 10.5534/wjmh.240012. Epub 2024 Jul 3.

Abstract

PURPOSE

Irreversible electroporation (IRE) is a promising alternative treatment for low-intermediate-risk localized prostate cancer. In this systematic review we aim to evaluate the safety profile and functional and oncological outcomes of this new technique.

MATERIALS AND METHODS

A systematic review of the literature was performed on PubMed, EMBASE, and Scopus up to 24 August 2023. Nineteen studies were analyzed, including 12 prospective studies and 7 retrospective studies. A total of 1,452 patients underwent IRE as the sole primary treatment modality.

RESULTS

The in-field clinically significant prostate cancer rate was reported between 0%-15.6% in the repeat biopsy. The retreatment rate was reported from 8% to 36.6%. The 3 years failure-free survival was presented between 90%-96.8%. The post-operative pad-free rate ranged between 96.7%-100%. Greater heterogeneity exists considering the change in erectile function. The most common reported complications were urinary tract infection and hematuria. Major complications were rare.

CONCLUSIONS

These results underline that IRE achieves favorable oncological control with an excellent safety profile, in the meantime preserving patients' urinary and erectile function.

摘要

目的

不可逆电穿孔(IRE)是一种治疗低中风险局限性前列腺癌的有前景的替代疗法。在本系统评价中,我们旨在评估这项新技术的安全性、功能及肿瘤学结局。

材料与方法

截至2023年8月24日,在PubMed、EMBASE和Scopus上对文献进行了系统评价。分析了19项研究,包括12项前瞻性研究和7项回顾性研究。共有1452例患者接受IRE作为唯一的主要治疗方式。

结果

重复活检时,靶区内具有临床意义的前列腺癌发生率为0%至15.6%。再次治疗率为8%至36.6%。3年无失败生存率为90%至96.8%。术后无尿垫率在96.7%至100%之间。考虑到勃起功能的变化,存在更大的异质性。最常见的并发症是尿路感染和血尿。严重并发症罕见。

结论

这些结果强调,IRE在实现良好肿瘤学控制的同时具有出色的安全性,同时保留了患者的泌尿和勃起功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34b7/11937361/78603594d0d6/wjmh-43-321-g001.jpg

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