Aim: To evaluate the efficacy and safety of superselective embolization and chemoembolization of the prostatic artery as an independent method of treating prostate cancer and BPH.
Materials And Methods: From 2004 to 2015, 116 patients with BPH (mean age 73.2+/-5.2 years) underwent prostatic artery embolization. Mean prostate volume ranged from 55 to 296 cc3. From 2011 to 2015, 37 patients with prostate cancer (mean age 72.3+/-2.06 years) were treated with X-ray-guided endovascular chemoembolization. All patients had confirmed PCa, of whom 7 had stage T2a and 30 stage T2c disease. PSA ranged from 0.8 to17 ng/ml (mean 13.1+/-3.9). Prostate volume ranged from 61 to 93 cc3 (mean 69.4+/-9.3). The follow-up ranged from 8 to 42 months.
Results: Prostatic artery embolization in BPH patients resulted in a significant reduction in IPSS symptom score and increase in Qmax. The volume of prostate and nodular mass decreased on average by 53% and 47%, respectively, maximum by 82%. Chemoembolization was effective in 31 (83.7%) patients. An objective response was achieved in reducing the PSA level and prostate volume measured by TRUS, and improved urination. The median PSA at 6 months was - 3.4 +/- 0.02 ng/ml. In all patients, chemoembolization resulted in a marked reduction in the prostate volume. The greatest decrease in the prostate volume was observed at 6 months after treatment. Chemoembolization led to a marked improvement in the quality of urination confirmed by uroflowmetry and IPSS symptom scores. At 12 months, 16 patients with prostate cancer underwent the follow-up biopsy. In 12 cases pathology showed fibrosis and epithelial degeneration without signs of atypia and in 2 cases curative pathomorphosis was observed. Chemoembolization was well tolerated and did not cause any significant complications.
Conclusion: Embolization techniques for BPH and chemoembolization for localized PCa showed good effectiveness and safety in patients who had medical contraindications to traditional treatments.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.18565/urol.2017.1.54-60 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Infiltrating lipid-rich macrophage subpopulations identified as a regulator of increasing prostate size in human benign prostatic hyperplasia.
Front Immunol
January 2025
Division of Urology, Department of Surgery, Endeavor Health (formerly NorthShore University HealthSystem), Evanston, IL, United States.
Introduction: Macrophages exhibit marked phenotypic heterogeneity within and across disease states, with lipid metabolic reprogramming contributing to macrophage activation and heterogeneity. Chronic inflammation has been observed in human benign prostatic hyperplasia (BPH) tissues, however macrophage activation states and their contributions to this hyperplastic disease have not been defined. We postulated that a shift in macrophage phenotypes with increasing prostate size could involve metabolic alterations resulting in prostatic epithelial or stromal hyperplasia.
View Article and Find Full Text PDFFirst-in-Men Online Adaptive Robotic Stereotactic Body Radiation Therapy: Toward Ultrahypofractionation for High-Risk Prostate Cancer Patients.
Adv Radiat Oncol
February 2025
Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Purpose: Ultrahypofractionation presents challenges for a subset of high-risk prostate cancer patients due to the large planning target volume (PTV) margin required for the seminal vesicles. Online adaptive radiation therapy could potentially reduce this margin. This paper focuses on the development, preclinical validation, and clinical testing of online adaptive robotic stereotactic body radiation therapy for this patient group.
View Article and Find Full Text PDFPSMA PET/CT based multimodal deep learning model for accurate prediction of pelvic lymph-node metastases in prostate cancer patients identified as candidates for extended pelvic lymph node dissection by preoperative nomograms.
Eur J Nucl Med Mol Imaging
January 2025
Department of Nuclear Medicine, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, P.R. China.
Purpose: To develop and validate a prostate-specific membrane antigen (PSMA) PET/CT based multimodal deep learning model for predicting pathological lymph node invasion (LNI) in prostate cancer (PCa) patients identified as candidates for extended pelvic lymph node dissection (ePLND) by preoperative nomograms.
Methods: [Ga]Ga-PSMA-617 PET/CT scan of 116 eligible PCa patients (82 in the training cohort and 34 in the test cohort) who underwent radical prostatectomy with ePLND were analyzed in our study. The Med3D deep learning network was utilized to extract discriminative features from the entire prostate volume of interest on the PET/CT images.
PSMA-targeted delivery of docetaxel in prostate cancer using small-sized PDA-based micellar nanovectors.
J Control Release
January 2025
Asymmetric Synthesis and Functional Nanosystems Group (Art&Fun), Institute of Chemical Research (IIQ), CSIC-University of Seville, C/ Américo Vespucio 49, 41092 Seville, Spain. Electronic address:
In this study, we present the first comparative analysis of active and passive drug delivery systems for docetaxel (DTX) in prostate cancer using supramolecular self-assembled micellar nanovectors. Specifically, we developed two novel micelles based on polydiacetylenic amphiphiles (PDA) for passive and active targeting. The active targeting micelles were designed with a prostate-specific membrane antigen (PSMA) ligand, ACUPA, to facilitate recognition by PSMA-positive cancer cells.
View Article and Find Full Text PDFTransition zone-based prostate-specific antigen density for differentiating clinically significant prostate cancer in PI-RADS score 3 lesions.
Sci Rep
January 2025
Department of Radiology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People's Hospital, Yancheng, China.
We intended to investigate the potential of several transitional zone (TZ) volume-related variables for the detection of clinically significant prostate cancer (csPCa) among lesions scored as Prostate Imaging Reporting and Data System (PI-RADS) category 3. Between September 2018 and August 2023, patients who underwent mpMRI examination and scored as PI-RADS 3 were queried from our institution. The diagnostic performances of prostate-specific antigen density (PSAD), TZ-adjusted PSAD (TZPSAD), and TZ-ratio (TZ volume/whole gland prostate volume) were analyzed.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!