CalliSpheres载药微球经前列腺动脉化疗栓塞治疗晚期前列腺癌伴出血的疗效和安全性  

Efficacy and safety of CalliSpheres drug-eluting beads prostatic artery chemoembolization in the treatment of advanced prostate cancer with hematuria

作　　者：刘松 刘梅晓 王庆东 于广计 LIU Song;LIU Meixiao;WANG Qingdong;YU Guangji(Department of Intervention,Linyi Cancer Hospital,Linyi Shandong 276034,China)

机构地区：[1]临沂市肿瘤医院介入治疗科,山东临沂276034

出　　处：《江苏大学学报（医学版）》2023年第5期380-385,共6页Journal of Jiangsu University：Medicine Edition

基　　金：临沂市重点研发计划项目(2022YX0021)。

摘　　要：目的:探讨CalliSpheres载药微球经前列腺动脉化疗栓塞(drug-eluting beads prostatic artery chemoembolization,DEB-PACE)治疗晚期前列腺癌伴出血的疗效及安全性。方法:回顾性分析2020年1月至2022年12月临沂市肿瘤医院收治的27例晚期前列腺癌伴出血患者的临床资料,所有患者均进行了前列腺动脉栓塞术的治疗,依据栓塞材料不同分为观察组(11例)和对照组(16例)。观察组患者采用CalliSpheres载药微球加载表柔比星20~30 mg进行栓塞治疗,对照组患者采用8Spheres空白栓塞微球进行栓塞治疗。观察两组患者出血控制情况,比较两组患者术前与术后2周、1个月、3个月时前列腺特异性抗原、国际前列腺症状评分、前列腺体积、生活质量QOL评分变化,分析两组患者无出血生存期和总生存期(overall survival,OS),记录治疗相关不良反应。结果:两组患者均成功完成相应栓塞治疗,技术成功率100%(27/27);止血成功率为85.19%(23/27),其中,观察组为90.91%(10/11),对照组为81.25%(13/16),两组比较差异无统计学意义(χ^(2)=0.038,P=0.845);观察组患者无出血持续时间为98 d,高于对照组的55 d(χ^(2)=22.071,P<0.001)。观察组患者术后2周、1个月、3个月时及对照组患者术后2周、1个月时前列腺特异性抗原、前列腺体积、国际前列腺症状评分、生活质量QOL评分均较术前明显降低(P均<0.05),对照组患者术后3个月各指标基本恢复至术前水平(P均>0.05)。两组与栓塞治疗相关的不良反应主要为疼痛、发热、恶心呕吐等,对症治疗后好转,未见异位栓塞等严重并发症,两组患者的各不良反应比较无显著差异(P均>0.05)。截至2023年3月1日,中位随访时间23个月,平均(21.89±8.31)个月,观察组中位总生存期为28个月,对照组为20个月,差异有统计学意义(χ^(2)=5.128,P=0.024)。结论:DEB-PACE治疗晚期前列腺癌合并出血可以获得更好的肿瘤控制率,更长的无出血生存期和总生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 DEB-PACE(CalliSpheres drug-eluting 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(χ^(2)=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(χ^(2)=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 relat

关 键 词：前列腺癌 血尿 前列腺动脉栓塞术 载药栓塞微球 

分 类 号：R737.25[医药卫生—肿瘤]