ArticleClinical and translational radiation oncology2025
Neoadjuvant prostate artery embolization prior to prostate radiation therapy: A single institution experience on the durability of clinical urinary improvement after radiation.
Article in Clinical and translational radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Management of lower urinary tract symptoms before prostate cancer radiotherapy: a call for innovative strategies.World journal of urology · 2026Review
- Current considerations in prostate artery embolisation.CVIR endovascular · 2026Article
- New Frontier for Prostate Artery Embolization: Neoadjuvant PAE before Radiation Therapy in Patients with Prostate Cancer.Radiology. Imaging cancer · 2025Article
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Radiation therapy (RT) for prostate cancer has gastrointestinal and genitourinary toxicities, greater with baseline lower urinary tract symptoms (LUTS) and larger prostate volume (PV). Prostate artery embolization (PAE) improves LUTS and PV before RT. This study evaluates the durability of LUTS improvement from neoadjuvant PAE before prostate RT and oncologic outcomes. Methods: We retrospectively identified patients receiving definitive prostate RT following PAE from a prospective database, including International Prostate Symptom Scores (IPSS), pre- and post-PAE MRI PV, and toxicity per CTCAEv5.0. Primary objective was LUTS by IPSS. Secondary objectives included biochemical recurrence-free survival (bRFS), local recurrence, and distant metastasis. Results: From 9/2017-5/2024, 82 patients underwent PAE before RT, with 30.5 % having unfavorable intermediate risk. RT consisted of conventional fractionation (n = 21), moderate hypofractionation (n = 42), SBRT (n = 11), and EBRT/brachytherapy boost (n = 8); a subset of patients received androgen deprivation therapy. Pelvic lymph nodes were treated in 28 (34 %) patients. Median pre-PAE IPSS was 18 (range 2-34), PV 90 cc (14.2-240), and PSA 8.4 ng/mL (0.02-125.5). Post-PAE, mean IPSS reduction was 10.7 points (-13-30). Mean PV reduction was 30.9 cc (-9-136) or 32 %. PAE converted 52 % of patients contraindicated by size/IPSS for brachytherapy/SBRT. Post-RT, mean IPSS changes at 3, 6, 12, 18 and 24 months were -8.7, -8.5, -9.5, -8.9, and -7.6, respectively ( Conclusion: Urinary improvement is durable after RT in men with large prostates and/or high LUTS burden with neoadjuvant PAE, and no increased risk of recurrence at intermediate-term follow-up. Further investigation is warranted.
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