Saldutto Pietro, Cavacece Fernando, Rocca Roberto La, Di Mauro Ernesto, Verratti Vittore, Sangiorgi Giuseppe Massimo, Vena Walter, Patelli Gianluigi, Iacono Fabrizio, Di Bello Francesco, Napolitano Luigi, Altieri Vincenzo Maria
Department of Urology, Humanitas Gavazzeni, 24125 Bergamo, Italy.
Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy.
Cancers (Basel). 2025 Feb 16;17(4):661. doi: 10.3390/cancers17040661.
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.
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.
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.
Vascular-targeted photodynamic therapy is a safe and effective alternative to active surveillance in patients with low-risk prostate cancer.
前列腺癌（PCa）是全球最常见的癌症之一。前列腺癌的标准筛查和诊断方法一直很有效，但可能导致对惰性前列腺癌的过度治疗，从而增加发病率。多参数磁共振成像（MRI）和融合活检是提高诊断准确性的有效工具。多参数MRI与光动力疗法相结合可作为低风险前列腺癌主动监测的替代方法，以更好地检测疾病进展，同时避免过度治疗。
我们对13例接受血管靶向光动力治疗的低风险前列腺癌患者进行了一项回顾性多中心研究。术后对患者进行长达15个月的评估，使用血清前列腺特异性抗原（PSA）等生化参数、直肠指检、多参数MRI，以及国际前列腺症状评分（IPSS）、15项国际勃起功能指数问卷（IIEF-5）、生活质量评分（QoL）、国际尿失禁咨询问卷简表（ICIQ-SF）和尿流率检查等功能参数。
患者在治疗期间及治疗后均未出现任何严重并发症。血清PSA和前列腺体积从7.38 ng/mL降至3.8 ng/ml，IPSS（从15.4降至11）、QoL（从3.15降至2）和IIEF-5（从17.23降至16）评分降低，尿流率改善，表明功能得到改善。
血管靶向光动力疗法是低风险前列腺癌患者主动监测的一种安全有效的替代方法。
