The Efficacy and Safety of Composite Steep-pulse Treatment Apparatus Used in Prostate Cancer Focal Therapy

Background:

Prostate cancer is the most common cancer in elderly males in western country. It is also a major health concern, especially in China with its greater proportion of elderly men in the general population. Currently, radical prostatectomy(RP) is the mainstream treatment for localized PCa to show a benefit for cancer-specific survival (CSS). However, the patient who underwent RP might suffer from the complication of erectile dysfunction or urinary incontinence. In 2004, a new method using steep pulses to treat tumor was appeared. It showed that steep pulses could bring about Irreversible Electroporation (IRE) of cell, leading tonecrosis of tumor cells. And it seemed to do no harms to the nerve and Vascular epithelial cell. The device of steep pulse had already been approved by FDA in 2011.However, this device of steep pulse has disadvantages like: (1)sever muscle contraction;(2)Urethral injury; (3)Capsule injury;(4)Nerve degeneration. This new device which is called Composite Steep-pulse Treatment Apparatus, may have the potential to conquer these disadvantages.

Purpose:

• This study will assess the efficacy of Composite Steep-pulse Treatment Apparatus in the treatment of PCa.
• This study will assess potency, urinary continence and complication rate for the patients undergo the treatment with steep pulse device.
• Histopathological analysis of prostate speciem 4 weeks after treated by Composite Steep-pulse Treatment Apparatus.

Methods:

• patients recruitment
• transperineal prostate targeted biopsy guided by multiparametric magnetic resonance imaging/transrectal ultrasound (mpMRI/TRUS) fusion, plus systemic prostate biopsy.
• Frozen pathological analysis will be performed;
• Irreversible Electroporation of malignant Tumor Cell under Composite Steep-pulse Treatment for the patients with positive biopsy;
• Complication, urinary continence, and sexual function will be evaluated after the IRE treatment;
• RP for these patients in 4 weeks after the treatment of Composite Steep-pulse Treatment.
• Histopathological Outcomes analysis will be performed to evaluate tumor residual rate, urethral injuries, nerve injuries and capsule injury in and beside the ablation area.

Inclusion criteria

• Prostate MRI can identify the suspect region(pi-RADS≥4 ) ,and no evidence of lymphatic metastasis
• Patients must have confirmed prostate cancer by prostate biopsy
• There must be no evidence of metastatic disease as confirmed by ECT and whole-body MRI
• No prostatic calculus or prostatic calculus≤5mm
• No contraindication on total intravenous anesthesia
• Not take any anticoagulants before or discontinue anticoagulant therapy at least 7 days
• Age ≥ 30 - ≤ 75 years
• Life expectancy of greater than 10 years
• Patients scheduled for radical prostatectomy.
• Sexually potent

Exclusion criteria

• Patients have previously undergone radical prostatectomy.
• Patients have previously undergone hormonal therapy or radiotherapy.
• Patients underwent other surgery before less than 3 months
• Clinically significant cardiovascular disease
• Patients with other malignant tumor or patients with hiv.
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• Patients with poor health condition
• Simultaneous participation in another clinical trial