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Prostatic Artery Embolization in Patients with Advanced Prostate Cancer: A Prospective Single Center Pilot Study

  • Clinical Investigation
  • Embolisation (arterial)
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To assess efficacy and safety of prostatic artery embolization (PAE) in patients with advanced prostate cancer (PCa).

Materials and Methods

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.

Results

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.

Conclusions

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.

Trials registration: NCT03457805.

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Acknowledgements

The authors thank the Clinical Trials Unit, Kantonsspital St. Gallen, and initial trial statistician Sabine Güsewell. Boston Scientific provided Embozene microspheres for study patients free of charge. The company did not influence design, conduct, and analysis of the study.

Funding

Costs for the trial were covered by the research funds of the participating departments.

Author information

Authors and Affiliations

  1. Department of Urology, School of Medicine, University of St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland

    Orlando Burkhardt, Dominik Abt, Hans-Peter Schmid, Daniel Engeler, Valentin Zumstein & Gautier Müllhaupt

  2. Department of Urology, Spitalzentrum Biel/Centre Hospitalier Bienne, Biel/Bienne, Switzerland

    Dominik Abt

  3. Department of Radiology and Nuclear Medicine, St. Gallen Cantonal Hospital, St. Gallen, Switzerland

    Lukas Hechelhammer & Olaf Kim

  4. Onkozentrum Zürich und Uroonkologisches Zentrum, Hirslanden Zürich, Seestrasse 259, 8038, Zurich, Switzerland

    Aurelius Omlin

  5. Urologiezug, Zug, Switzerland

    Valentin Zumstein

  6. Department of Urology, Spital Thun, Thun, Switzerland

    Gautier Müllhaupt

Authors
  1. Orlando Burkhardt
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  2. Dominik Abt
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  6. Hans-Peter Schmid
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  7. Daniel Engeler
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  9. Gautier Müllhaupt
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Corresponding author

Correspondence to Orlando Burkhardt.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Burkhardt, O., Abt, D., Hechelhammer, L. et al. Prostatic Artery Embolization in Patients with Advanced Prostate Cancer: A Prospective Single Center Pilot Study. Cardiovasc Intervent Radiol (2024). https://doi.org/10.1007/s00270-024-03679-z

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  • DOI: https://doi.org/10.1007/s00270-024-03679-z

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