Follow-up of vascular-targeted photodynamic therapy in a real-world setting

Purpose Vascular-targeted photodynamic therapy (VTP) is an approved treatment option for unilateral low-risk prostate cancer (PCa).

Methods Patients with unilateral low- or intermediate-risk PCa undergoing hemiablation by VTP were evaluated in a real-world setting.

Oncological outcome after VTP was measured by MRI-based re-biopsy at 12 and 24 months.

Functional outcome after 1 year was investigated by IIEF-5 and IPSS questionnaires.

Progression was defined as the evidence3 of ISUP ≥ 2 PCa.

Results At any control biopsy ( n  = 46) after VTP, only 37% of patients showed no evidence of PCa.

Recurrence-free survival was 20 months (95% CI 4.9–45.5) and progression-free survival was 38.5 months (95% CI 33.5–43.6 months).

In-field and out-field recurrent PCa occurs in 37% (55% ISUP ≥ 2 PCa) and 35% (56% ISUP ≥ 2 PCa).

Seventy-nine percent of patients preserved erectile function, respectively.

Ten percent of patients presented long-term bladder outlet obstruction.

None of the patients presented incontinence.

Conclusion Due to the high-recurrence in- and out-field recurrence rate in a mainly low-risk prostate cancer cohort, VTP has to be regarded critically as a therapy option in these patients.

Pre-interventional diagnostic evaluation is the main issue before focal therapy to reduce the risk of tumor recurrence and progression.