Prostate Cancer Clinical Trial
Official title:
A Prospective Development Study Evaluating Focal Therapy Using Encage Coiled Bipolar Radiofrequency Ablation in Men With Localised Prostate Cancer
To assess the early histological outcomes of tissue ablation, adverse events and genitourinary side-effect profile of focal radiofrequency ablation using a coiled bipolar device to treat localized prostate cancer in men with clinically significant prostate cancer.
The study aims to assess the ability of focal therapy using coiled bipolar radiofrequency
device to ablate a pre-defined target tissue zone as well as assess side-effects. The medical
device has a coiled configuration and creates thus a "Faraday cage" effect, preventing
surrounding tissue damage and the bipolar configuration produces complete tissue thermo
coagulation within the limits the coil.
Thereof it is proposed to conduct a prospective development study, offering focal therapy
coiled bipolar radiofrequency ablation to men with histologically proven localized prostate
cancer which is clinically significant.
Localization and characterization of the disease will be established using multi-parametric
magnetic resonance imaging (mp-MRI) and transperineal prostate biopsies. Magnetic resonance
(MR)-visible, clinically significant disease will be targeted and focally treated with a
margin of normal tissue as big as anatomically possible to obtain an adequate margin of
normal tissue around the lesion for effective ablation. Secondary lesions meeting criteria
for clinical insignificance will be left untreated and undergo surveillance.
Pre-operative and all post operative imaging will be performed using a scanner and a pelvic
phased array receiver, with a pelvic coil. A full protocol of T1 and T2 weighted turbo-spin
echo images and a dynamic post gadolinium volume acquisition will be used for both
pre-operative diagnostic and planning scans and post-operative assessment by use of the
medical device.
The initial transperineal biopsy will already have been performed, prior to invitation to
participate in the study, and demonstrating eligibility for inclusion.
The process will involve targeted or mapping biopsies which are concordant with the lesion
seen on MRI. In both cases, transperineal biopsies will be taken from the prostate using a
brachytherapy grid placed over the perineal skin whilst the man is in the lithotomy position.
They will be given as much time as they need to consider whether or not patients wish to
participate. The ones who wish to participate after reading the patient information sheet
will undergo a screening visit (first visit) to ascertain whether or not they are eligible
for the trial. If so, they will proceed to focal radiofrequency ablation using a coiled
bipolar device(second visit), and will be seen at further follow-up visits.
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