Published online Mar 26, 2016. doi: 10.5662/wjm.v6.i1.65
Peer-review started: July 19, 2015
First decision: November 7, 2015
Revised: February 3, 2016
Accepted: February 23, 2016
Article in press: February 24, 2016
Published online: March 26, 2016
Processing time: 246 Days and 10.6 Hours
Vascular targeted photochemotherapy (VTP) holds promise as a novel strategy of the focal treatment of localised prostate cancer (LPCa). It is convenient to perform, minimally invasive and can be conduct in ambulatory conditions. In this review, methodologic aspects of padoporfin- and padeliporfin-mediated VTP and its clinical application in focal treatment of LPCa as well as future perspective of this method were presented. Physicochemical and pharmacokinetic parameters of padoporphin and padeliporfin using as VTP photosensitizers were described, as well as methodologic question of radiation delivery and dosimetry, and oxygen monitoring in cancer tissue in context of VTP safety and efficiency of LPCa focal therapy were discussed. The results of clinical trials concerning application of padoporfin- and padeliporfin-mediated VTP in LPCa were also presented. The future of VTP is development of protocols, founded on the real-time feedback and rules-based approach to make this strategy a standard procedure in LPCa treatment. To evaluate clinical potential of this procedure, a cost-effectiveness analysis is also necessary.
Core tip: Vascular targeted photochemotherapy (VTP) represents new paradigm in focal therapy of prostate cancer (PCa). Physicochemical, pharmacodynamic and pharmacokinetic properties of padoporfin and padeliporfin, which are palladium derivatives of bacteriochlorin, make them suitable photosensitizers for VTP. Good visualisation of tumours and selective targeting of tumour lesion are mandatory for VTP to be efficient. Results of clinical trials confirm safety and efficiency of VTP in treatment of PCa. New protocols are necessary to make VTP standard method of PCa therapy.