Bing Yuan1, Hainan Xin1, Jin Xin Fu1, Mao Qiang Wang2, Jin Long Zhang3, Feng Duan1, Hui Yi Ye4, Hong Kai Yu5, Dui-Ping Feng6, Kai Cheng7, Xiu Jun Zhang8. 1. Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, 100853, P. R. China. 2. Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, 100853, P. R. China. wangmq@vip.sina.com. 3. Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, PR China. 4. Department of Diagnostic Radiology, Chinese PLA General Hospital, Beijing, 100853, P. R. China. 5. Department of Urology, Chinese PLA General Hospital, Beijing, 100853, P. R. China. 6. Department of Oncology and Vascular Intervention, The First Hospital of Shanxi Medical University, Taiyuan, 030001, China. 7. Department of Interventional Radiology, Qingdao Municipal Hospital, Qingdao, 266071, China. 8. Department of Interventional Radiology, Tianjin Nankai Hospital, Tianjin, 300193, China.
Abstract
OBJECTIVES: To evaluate the safety and efficacy transcatheter arterial chemoembolization (TACE) for the treatment of refractory gross hematuria (RGH) and urinary retention (UR) secondary to localized advanced prostate cancer (PCa). PATIENTS AND METHODS: Thirty-two patients (mean age 72.5 years, range 60-89) with advanced PCa-related RGH that failed conventional therapy were included. Twenty-two of these patients had catheter-dependent due to PCa-related UR. TACE was performed with epirubicin (EPI)-eluting HepaSpheres (HS) plus intra-arterial (IA) infusion of docetaxel. Technical success, adverse events (AEs), overall survival (OS), control of RGH, removal of indwelling catheters, and local disease control, were evaluated. RESULTS: Technical success was achieved in 100% without major AEs. Mean follow up post-TACE was 27 months (range 8-56 months) with a mean OS of 30 months. GRH stopped within 5 days after TACE in all patients, 26 (86.7%) of these patients exhibited good bleeding control during a mean follow-up of 24 months; 17 (77.3%) of the 22 patients with UR had recovered spontaneous urination, 15 (88.2%) patients were catheter-free at their last follow-up with a mean of 24 months. BS was obtained in 73.3% (22/30) of patients at a mean follow-up of 29 months. At the last visit, 22 patients had a mean of 36 months follow-up and the mean percentage reduction in prostate volume was 55.5%, with a statistically different from baseline (P = 0.022). Negative biopsy results were obtained in 84.2% (16/19) of the patients at 12-47 months after TACE. Compared with baseline values, there was a significant improvements in IPSS, QoL, Qmax, and PVR (all P < 0.05). CONCLUSIONS: TACE using EPI-eluting HS plus IA infusion of docetaxel is a safe and effective treatment option for the advanced PCa patients with GRH and UR, and it could be considered as an alternative if there was no other therapeutic choice.
OBJECTIVES: To evaluate the safety and efficacy transcatheter arterial chemoembolization (TACE) for the treatment of refractory gross hematuria (RGH) and urinary retention (UR) secondary to localized advanced prostate cancer (PCa). PATIENTS AND METHODS: Thirty-two patients (mean age 72.5 years, range 60-89) with advanced PCa-related RGH that failed conventional therapy were included. Twenty-two of these patients had catheter-dependent due to PCa-related UR. TACE was performed with epirubicin (EPI)-eluting HepaSpheres (HS) plus intra-arterial (IA) infusion of docetaxel. Technical success, adverse events (AEs), overall survival (OS), control of RGH, removal of indwelling catheters, and local disease control, were evaluated. RESULTS: Technical success was achieved in 100% without major AEs. Mean follow up post-TACE was 27 months (range 8-56 months) with a mean OS of 30 months. GRH stopped within 5 days after TACE in all patients, 26 (86.7%) of these patients exhibited good bleeding control during a mean follow-up of 24 months; 17 (77.3%) of the 22 patients with UR had recovered spontaneous urination, 15 (88.2%) patients were catheter-free at their last follow-up with a mean of 24 months. BS was obtained in 73.3% (22/30) of patients at a mean follow-up of 29 months. At the last visit, 22 patients had a mean of 36 months follow-up and the mean percentage reduction in prostate volume was 55.5%, with a statistically different from baseline (P = 0.022). Negative biopsy results were obtained in 84.2% (16/19) of the patients at 12-47 months after TACE. Compared with baseline values, there was a significant improvements in IPSS, QoL, Qmax, and PVR (all P < 0.05). CONCLUSIONS: TACE using EPI-eluting HS plus IA infusion of docetaxel is a safe and effective treatment option for the advanced PCa patients with GRH and UR, and it could be considered as an alternative if there was no other therapeutic choice.
Authors: Henk G van der Poel; Roderick C N van den Bergh; Erik Briers; Philip Cornford; Alex Govorov; Ann M Henry; Thomas B Lam; Malcolm D Mason; Olivier Rouvière; Maria De Santis; Peter-Paul M Willemse; Hendrik van Poppel; Nicolas Mottet Journal: Eur Urol Date: 2018-01-17 Impact factor: 20.096
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Authors: Martin G Sanda; Jeffrey A Cadeddu; Erin Kirkby; Ronald C Chen; Tony Crispino; Joann Fontanarosa; Stephen J Freedland; Kirsten Greene; Laurence H Klotz; Danil V Makarov; Joel B Nelson; George Rodrigues; Howard M Sandler; Mary Ellen Taplin; Jonathan R Treadwell Journal: J Urol Date: 2017-12-15 Impact factor: 7.450