Lucas-Cava Vanesa, Sánchez-Margallo Francisco Miguel, Sun Fei
Endoluminal Therapy and Diagnosis Unit, Jesús Usón Minimally Invasive Surgery Centre, Road N-521, Km 41.8, 10071, Cáceres, Spain.
Scientific Director, Jesús Usón Minimally Invasive Surgery Centre, Road N-521, Km 41.8, 10071, Cáceres, Spain.
Cardiovasc Intervent Radiol. 2025 Jul 10. doi: 10.1007/s00270-025-04107-6.
Prostatic artery embolization (PAE) has received attention to manage the urological symptoms in patients with prostate cancer (PCa). This meta-analysis evaluates its effectiveness and safety in patients with PCa.
A systematic review was performed by searching in PudMed and Web of Science databases for studies including either PAE or prostatic artery chemoembolization (PACE) in patients with PCa. Quantitative and qualitative analyses were performed. The primary outcomes were technical success, clinical success, oncological efficacy and adverse events (AEs). The secondary outcomes were International Prostate Symptoms Score (IPSS), quality of life (QoL), prostate volume (PV), and prostate-specific antigen (PSA).
Eleven single-arm studies with 151 participants were included. The pooled technical and clinical success rates were 95.53% (95%CI: 87.23, 99.95) and 90.31% (95%CI: 73.44, 99.85), respectively, whereas the oncological efficacy was 65.89% (95%CI: 32.18, 93.13). AEs showed low rates of minor 23.88% (95%CI: 8.88, 42.39) and major 0.6% (95%CI: 0.00, 3.67). Although, PAE tended to fewer AEs compared to PACE, 20.76% vs 31.03% for minor, and 1.01% vs 0.32% for major AEs, respectively. In addition, there was a statistically significant reduction in IPSS (- 10.24, 95%CI: - 14.60,- 5.89), QoL (- 2.28, 95%CI: - 3.25, - 1.32), PV (- 22.16, 95%CI: - 34.20, - 10.13), and PSA (- 7.32, 95%CI: - 12.34, - 2.29), with greater improvements after PACE. Overall, the studies showed a high risk of bias.
This meta-analysis revealed that PAE and PACE are feasible, effective, and safe techniques to control the urological symptoms in patients with PCa, and even as adyuvant treatment for local therapies.
前列腺动脉栓塞术（PAE）已受到关注，用于管理前列腺癌（PCa）患者的泌尿系统症状。本荟萃分析评估其在PCa患者中的有效性和安全性。
通过在PubMed和Web of Science数据库中检索，对包括PAE或前列腺动脉化疗栓塞术（PACE）的PCa患者研究进行系统评价。进行了定量和定性分析。主要结局为技术成功率、临床成功率、肿瘤学疗效和不良事件（AE）。次要结局为国际前列腺症状评分（IPSS）、生活质量（QoL）、前列腺体积（PV）和前列腺特异性抗原（PSA）。
纳入了11项单臂研究，共151名参与者。汇总的技术成功率和临床成功率分别为95.53%（95%CI：87.23，99.95）和90.31%（95%CI：73.44，99.85），而肿瘤学疗效为65.89%（95%CI：32.18，93.13）。AE显示轻微AE发生率较低，为23.88%（95%CI：8.88，42.39），严重AE发生率为0.6%（95%CI：0.00，3.67）。尽管与PACE相比，PAE的AE往往较少，轻微AE分别为20.76%对31.03%，严重AE分别为1.01%对0.32%。此外，IPSS（-10.24，95%CI：-14.60，-5.89）、QoL（-2.28，95%CI：-3.25，-1.32）、PV（-22.16，95%CI：-34.20，-10.13）和PSA（-7.32，95%CI：-12.34，-2.29）有统计学显著降低，PACE后改善更大。总体而言，这些研究显示存在较高的偏倚风险。
本荟萃分析表明，PAE和PACE是控制PCa患者泌尿系统症状的可行、有效且安全的技术，甚至可作为局部治疗的辅助治疗。
