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晚期前列腺癌患者的前列腺动脉栓塞:一个潜在的单中心试点研究
Orlando Burkhardt1, Dominik Abt2,3, Lukas Hechelhammer4
1Department of Urology, School of Medicine, University of St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland. orlando.burkhardt@kssg.ch.
Cardiovascular and interventional radiology
|February 28, 2024
概括
前列腺动脉栓塞 (PAE) 在晚期前列腺癌 (PCa) 中显示出有前途的结果,改善了尿路症状和安全性. 虽然功能性结局是积极的,但在这个试点研究中,显著的瘤减少仅限于一名患者.
科学领域:
- 干预性放射学 干预性放射学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
背景情况:
- 晚期前列腺癌 (PCa) 在治疗方面存在重大挑战.
- 前列腺动脉栓塞 (PAE) 是一个新兴的微创治疗选择.
- 试点研究对于评估瘤学新型治疗方法至关重要.
研究的目的:
- 评估PAE在患有晚期前列腺癌 (PCa) 的男性的疗效和安全性.
- 评估PAE后的功能结果和瘤反应.
- 为了确定PAE的可行性,在这个患者群体中使用特定的微球大小.
主要方法:
- 一项前性,单中心,单臂试点研究,涉及9名患有高级PCa的男性.
- PAE使用250-400μm的Embozene微球进行.
- 评估国际前列腺症状评分 (IPSS),尿峰流量 (Qmax),空虚后残留尿量 (PVR),前列腺体积 (TPV) 和瘤体积 (TV) 在术后12周至12个月.
- 瘤反应通过PSA水平和多参数MRI评估瘤缩和回归.
主要成果:
- 在12周内,IPSS (中位数减少6点) 和PVR (中位数从70毫升减少到10毫升) 显著改善.
- 在12周观察到中位TPV和瘤体积的轻微增加.
- 显著的瘤缩 (≥50%) 仅发生在一名患者身上;八名患者在PAE后的MRI上有>50%的活跃瘤.
- 一例与PAE相关的Clavien-Dindo 1级不良事件.
结论:
- 使用250-400μm微球的PAE是可行的,安全的,并且有效地改善了高级PCa的选择患者的功能结果.
- 在个别情况下,可以实现细胞减少效应,这需要进一步调查.
- 需要进行更大规模的研究来确认PAE对晚期PCa瘤反应的疗效.
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