The Safety and Efficacy of Vascular-Targeted Photodynamic Therapy in Low-Risk Prostate Cancer.

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.