Vascular-targeted photodynamic therapy with TOOKAD® Soluble in localized prostate cancer: standardization of the procedure

Abstract

Introduction: Vascular-targeted photodynamic therapy with TOOKAD(®) Soluble is an innovative focal therapy procedure assessed in localized prostate cancer treatment.

Materials and methods: This mini-invasive technique destroys targeted tissues using a photosensitizer [TOOKAD(®) Soluble (WST11), STEBA Biotech] activated by laser light in the presence of oxygen. Its application for prostate cancer requires intravenous infusion of TOOKAD(®) Soluble and the illumination of the targeted area by transperineal optical fibers inserted under trans-rectal ultrasound guidance under general anesthesia.

Conclusion: Based on the experience gained through hundreds of procedures, we describe here the standardized technique of vascular-targeted photodynamic therapy with TOOKAD(®) Soluble defined during the phase II and III trials.

Trial registration: ClinicalTrials.gov NCT00707356 NCT00975429.

Fig. 1

TOOGUIDE^® treatment guidance. The position of the fibers is determined on either prostatic MRI/or prostatic ultrasound

Fig. 1

TOOGUIDE^® treatment guidance. The position of the fibers is determined on either prostatic MRI/or prostatic ultrasound

Fig. 2

Installation of the operating table, the ultrasound device and the brachystepper

Fig. 3

The operating room organization. The position of the material (right or left) depends on the habits of the urologist

Fig. 4

Cleaning the rectum

Fig. 5

The balloon, the saline syringe and the urethral gel

Fig. 6

The ultrasound probe, the balloon and the brachystepper device

Fig. 7

Reusable transperineal prostate template

Fig. 8

Fiber insertion catheter

Fig. 9

Safety margin for the optical fiber positions

Fig. 10

Laser generator

Fig. 11

VTP preoperative view