LIU Song, LIU Meixiao, WANG Qingdong, YU Guangji
Journal of Jiangsu University(Medicine Edition).
2023, 33(05):
380-385.
Objective: To explore the efficacy and safety of CalliSpheres drug-eluting beads prostatic artery chemoembolization (DEB-PACE) in the treatment of advanced prostate cancer with hematuria. Methods: From January 2020 to December 2022, the clinical data of 27 patients with advanced prostate cancer and hematuria admitted to Linyi Cancer Hospital were retrospectively analyzed. All patients received prostatic artery embolization(PAE). The patients were divided into observation group (11 cases) and control group (16 cases) according to different embolic materials. The observation group received DEBPACE (CalliSpheres drugeluting beads loaded with epirubicin of 20~30 mg), the control group were received 8Spheres embolic microspheres. The control of hematuria was observed; the changes of prostate specific antigen, international prostate symptom score, prostate volume, and quality of life QOL scores were compared before and after 2 weeks, 1 month, and 3 months of operation; the hematuria free survival time and overall survival (OS) time of the two groups were recorded; and the treatment related adverse reactions were also recorded. Results: The two groups of patients successfully were completed the corresponding embolization treatment, the technical success rate was 100% (27/27); the success rate of hemostasis was 85.19% (23/27), 90.91% (10/11) in the observation group and 81.25% (13/16) in the control group, with no significant difference(χ2=0.038,P=0.845); the duration of no hematuria in the observation group were 98 days, higher than that in the control group for 55 days (χ2=22.071, P<0.001). The prostate specific antigen, prostate volume, international prostate symptom score, and quality of life QOL score of the observation group patients at 2 weeks, 1 month, and 3 months after surgery, as well as the control group patients at 2 weeks and 1 month after surgery, were significantly lower than those before surgery (P<0.05). The control group patients basically recovered to their preoperative levels at 3 months after surgery (P>0.05). The main adverse reactions related to embolization therapy in the two groups were pain, fever, nausea, vomiting, etc. After symptomatic treatment, all main adverse reactions were attenuated without severe complications such as ectopic embolism. There was no significant difference in the adverse reactions between the two groups (P>0.05). By the end of March 1, 2023, the median followup time was 23 months, with an average of (21.89±8.31) months. The median OS in the observation group was 28 months, while in the control group was 20 months. The difference was statistically significant (χ2=5128, P=0024). Conclusion: DEB-PACE is a safe and feasible treatment for advanced prostate cancer with hematuria, which can obtain higher tumor control rate, longer hematuria free survival time and OS.