ESTRO 2025 - Abstract Book

S1881

Clinical - Urology

ESTRO 2025

161

Digital Poster Reduction of prostate volume by prostate artery embolization before radiotherapy of prostate cancer Hathal Haddad 1 , Claudia Klein 2 , Horst Hermani 2 , Peter Bischoff 3 , Attila Kovacs 3 , Michael Pinkawa 4 1 Department of Radiation Oncology, University Hospital Tübingen and Medical Faculty, Tübingen, Germany. 2 Department of Medical Physics, Wegeklinik, Bonn, Germany. 3 Department of interventional and diagnostic Radiology and Neuroradiology, Wegeklinik, Bonn, Germany. 4 Department of Radiation Oncology, Wegeklinik, Bonn, Germany Purpose/Objective: To verify the efficacy of prostate artery embolization (PAE) for reducing prostate volume (PV) before radiotherapy in patients with large prostate volumes (>100 cm³). Material/Methods: 3 patients with prostate cancer and with lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH) treated with prostate artery embolization (PAE) before external beam radiotherapy. MRI done Pre- & 2 months Post-PAE. IPSS evaluated before & after PAE. 3 gold markers implanted into the prostate & 10 ml of hydrogel injected between the prostate and rectum (2 Patients). Pre- and post-PAE treatment plans were done and evaluated on 2 CTs, 1st Plan on Pre-PAE CT 2nd the Plan on Post-PAE (EBRT Plan). The median follow-up was 37 months after PAE treatment.

Results: 3 patients with large PV > 100 cm³, with a mean age 80 (76-86). The mean reduction of prostate volume was 35% (15%-45%). Mean prostate volume before PAE was 132 cm³ (102 cm³-189 cm³), reduced to mean prostate volume Post-PAE of 84 cm³ (58 cm³-108cm³). Mean IPSS score reduced from 14 (8-22) to a mean IPSS post-PAE of 4 (2-7). The mean iPSA was 15 ng/ml (8.8-20.6 ng/ml), dropped 3 months after EBRT to mean 0.4 ng/ml (0.02-0.6 ng/ml). 1 patient had a PSA drop from 8.8 ng/ml to 2 ng/ml after PAE, to 1.4 ng/ml at the end of EBRT, and 0.6 ng/ml three months after EBRT. Mean dose exposure to the urinary bladder was reduced by > 56% in the dose range between 50Gy and 70Gy in the 2 Patients with Hydrogel and > 23% in the patients without Hydrogel.