Department of Urology, School of Medicine, University of St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland.
Department of Urology, Spitalzentrum Biel/Centre Hospitalier Bienne, Biel/Bienne, Switzerland.
Cardiovasc Intervent Radiol. 2024 Jun;47(6):771-782. doi: 10.1007/s00270-024-03679-z. Epub 2024 Feb 28.
To assess efficacy and safety of prostatic artery embolization (PAE) in patients with advanced prostate cancer (PCa).
In this prospective single-center, single-arm, pilot study, 9 men with advanced PCa underwent PAE. PAE was performed with the use of 250-400 µm Embozene microspheres (Boston Scientific, Natick, Massachusetts, USA). International Prostate Symptoms Score (IPSS), urinary peak flow (Qmax) and post-void residual urine volume (PVR) was assessed at 12 weeks and up to 12 months. Changes in total prostate volume (TPV) and tumor responses by PSA, changes in tumor volume and evaluation of tumor regression by multiparametric magnetic resonance imaging were assessed at 12 weeks after PAE.
IPSS reduction in median 6 points (0-19) and a significant decrease in PVR from median 70 (20-600) mL to 10 (0-280) mL could be achieved within 12 weeks after PAE. Median TPV and tumor volumes (TV) increased slightly from 19.7 (6.4-110.8) mL to 23.4 (2.4-66.3) mL and 6.4 (4.6-18.3) mL to 8.1 (2.4-25.6) mL at a median of 12 weeks after the procedure. Significant tumor necrosis (≥ 50%) was found in one patient. Eight patients showed > 50% of viable tumor on post-PAE MRI according to MRI. Only one Clavien-Dindo Grade 1 adverse event related to PAE occurred.
PAE with the use of 250-400 µm microspheres is feasible, safe and effective in some patients with advanced PCa regarding functional outcomes. A cytoreductive effect might be achieved in individual patients but must be further assessed.
NCT03457805.
评估前列腺动脉栓塞术（PAE）治疗晚期前列腺癌（PCa）的疗效和安全性。
本前瞻性单中心单臂试验纳入 9 例晚期 PCa 患者行 PAE 治疗。使用 250-400μm Embozene 微球（波士顿科学，马萨诸塞州纳蒂克）进行 PAE。在 12 周和 12 个月时评估国际前列腺症状评分（IPSS）、尿最大流率（Qmax）和剩余尿量（PVR）。在 PAE 后 12 周评估总前列腺体积（TPV）和前列腺特异性抗原（PSA）的肿瘤变化、肿瘤体积变化以及多参数磁共振成像（MRI）的肿瘤消退评估。
PAE 后 12 周，中位 IPSS 降低 6 分（0-19），PVR 从 70（20-600）ml 显著降至 10（0-280）ml。TPV 和肿瘤体积（TV）在 PAE 后 12 周时分别从 19.7（6.4-110.8）ml 和 6.4（4.6-18.3）ml 略微增加至 23.4（2.4-66.3）ml 和 8.1（2.4-25.6）ml。1 例患者发现明显肿瘤坏死（≥50%）。根据 MRI，8 例患者在 PAE 后 MRI 上显示>50%的存活肿瘤。仅 1 例发生与 PAE 相关的 Clavien-Dindo 1 级不良事件。
对于晚期 PCa 患者，使用 250-400μm 微球的 PAE 在功能结果方面是可行、安全且有效的。在个别患者中可能实现细胞减灭效果，但需进一步评估。
NCT03457805。
