动脉内化疗栓塞治疗晚期前列腺肉瘤的初步研究

Preliminary study of arterial chemoembolization for large prostate sarcoma

目的本研究目的是评估动脉内化疗栓塞治疗晚期前列腺肉瘤的可行性、安全性和短期疗效。方法收集2014年9月～2015年11月期间，7例晚期前列腺肉瘤患者因失去手术机会，接受了经导管动脉内化疗栓塞术。术中使用化疗药物为阿霉素和顺铂，栓塞材料使用直径为90—180μm聚乙烯醇微粒（PVA）。结果7例患者全部接受双侧前列腺动脉化疗栓塞。术后1个月的随访结果：盆腔磁共振显示肉瘤明显坏死，5例患者的前列腺肉瘤直径明显缩小。所有患者的血尿、排尿困难、会阴部疼痛、排便困难症状改善明显。无严重并发症发生。结论经导管动脉化疗栓塞术姑息治疗晚期前列腺肉瘤具备技术可行性和安全性，能有效改善临床症状。

Objective The aim of this study was to evaluate the feasibility, safety and short-term effectiveness of trans-catheter arterial chemoembolization for large prostate sarcoma especially in palliation. Methods Between September 2014 and November 2015, 7 patients with large prostate sarcoma with definitive diagnosis were enrolled and underwent palliative trans-catheter arterial chemoembolization. As anti-cancer agents, adriamycin and cisplatin were administered. Polyvinyl alcohol particles （PVA） with diameter of 90 - 180 μm were the initial embolic materials. Results Bilateral infusion and embolization was successful in all 7 cases. Patients were followed-up for 1 month with clinical and radiological examinations. There were no major complications during the follow-up period. Significant infarction of prostate sarcoma was detected on 1-month follow-up MRI examinations. Reduc- tions in mean prostate sarcoma size were found in 5 cases. The gross hematuria was primarily stopped in all patients. The follow- up showed significant improvement in sarcoma related symptoms including dysuria, perineal pain and constipation. Conclusion Palliative trans-catheter arterial chemoembolization for large prostate sarcoma could be a minimally invasive and safe procedure with good feasibility, safety and short-term effectiveness.