Prostatic Artery Embolization in Advanced Prostate Cancer
Prostatic Artery Embolization in Advanced Prostate Cancer
This is a pilot study assessing efficacy and safety in patients with advanced prostate
 cancer.
PAE has been shown to be safe and effective in the treatment of prostatic bleeding and lower
 urinary tract symptoms arising from bladder outlet obstruction.

 Advanced (defined as locally advanced, metastatic or both in this study) PCA is frequently
 associated with both of these conditions. The currently most frequently performed palliative
 surgical treatment is TURP. Though performed endoscopically, TURP is associated with
 significant side effects in this setting. PAE has been shown to have a superior side-effect
 profile in the treatment of bladder outlet obstruction compared to TURP.

 In addition, there is growing evidence that patients with advanced PCA might benefit from
 cytoreductive therapy (e.g. radical prostatectomy or external beam radiation therapy).
 However, recent methods of cytoreductive treatment of PCA hold the risk of being highly
 invasive and are associated with severe side effects. PAE might represent a minimally
 invasive alternative in this setting.

 Therefore, efficacy and safety of PAE in patients with advanced prostate cancer is assessed
 in this pilot-study.
Inclusion Criteria

 -  Advanced PCA (i.e., locally advanced, metastatic, combination of both. This includes
 T3-4, any T in case of N1 and any T in case of M1a/b/c)

 -  PAE is indicated for the treatment of Lower urinary tract symptoms like bladder outlet
 obstruction or recurrent prostatic bleeding.

 -  IPSS at baseline ≥ 8

 -  Witten informed consent

 Exclusion Criteria:

 -  Curative treatment of PCA intended

 -  Contraindications for MRI

 -  Renal impairment (GFR < 30ml/min)

 -  Allergy to i.v. contrast medium

 -  Vascular conditions that seem to make successful PAE impossible (e.g. severe
 atherosclerosis, severe tortuosity in the aortic bifurcation or internal iliac
 vessels)

 -  Inability to follow the procedures of the study, e.g. due to language problems,
 psychological disorders, dementia, etc. of the participant.

 -  Drug-treatments for advanced prostate cancer (e.g., hormonal therapy or chemotherapy)
 established within 30 days prior to PAE.