LUGPA 2025 Global Prostate Cancer Congress Enduring Program-GPCC 2025 Session 6

Video Transcription

Video Summary

The session on localized prostate cancer provided a comprehensive overview of emerging treatments, radiation oncology advances, comparative trials, and decision-making complexities in intermediate-risk cases. Dr. Orio began by setting the framework, noting the integration of research and clinical guidelines emphasizing focal therapies mainly within trials or registries. Dr. Tom highlighted the evolution of focal treatments such as cryotherapy, HIFU, and IRE, demonstrating consistent five-year outcomes with high cancer-specific survival and good functional results. He underscored the importance of patient selection and evolving imaging techniques like MRI and PSMA PET and reviewed ongoing trials exploring various ablation modalities.<br /><br />Dr. Peter focused on radiation oncology advances, emphasizing shorter, precise treatments like SBRT and the use of rectal spacers to protect normal tissue and minimize toxicity. He discussed the balance of side effects between radiation and surgery, stressing personalized counseling to optimize quality of life. Comparative studies show similar cancer control between surgery and radiation with differing side effect profiles.<br /><br />Dr. Jason presented the PARTICLE trial—a large phase III randomized study comparing proton therapy and IMRT in localized prostate cancer. The trial found no significant differences in bowel, urinary, or sexual quality of life outcomes nor disease control at five years, providing robust evidence that both modalities are equally effective and safe in favorable risk populations.<br /><br />Finally, Dr. Brian addressed the challenges of treating intermediate-risk prostate cancer, highlighting variability in patient progression and the role of multi-parametric risk stratification, including genomic classifiers, to guide management from active surveillance to focal or radical treatment. He noted the complexities of balancing oncologic control with side effects, stressing individualized, shared decision-making supported by modern imaging and molecular tools. Overall, the session illustrated the evolving landscape of localized prostate cancer treatment, emphasizing innovation, comparative effectiveness, and patient-centered care.

Keywords

localized prostate cancer

focal therapies

cryotherapy

HIFU

IRE

radiation oncology

SBRT

proton therapy

IMRT

intermediate-risk prostate cancer