Prostatic Artery Embolization for the Treatment of Patients with Localized Prostate Carcinoma and Obstructive Lower Urinary Tract Symptoms

Inclusion Criteria

• Histologically or cytologically confirmed prostate adenocarcinoma in the very low or low or favorable intermediate risk risk stratification groups (i.e. Gleason grade groups 1 and 2) who are eligible for and who select radiation therapy (XRT) as their cancer management method
• Ability to receive PAE within 6-12 weeks of definitive XRT
• Male
• Aged equal to or older than 50 years
• Ability to understand and the willingness to sign a written informed consent document
• Prostate larger than 60 grams but less than 150 grams, as assessed by imaging scans
• American Urological Association Symptom (AUA) or International Prognostic Scoring System (IPSS) score >= 15
• Leukocytes > 3,000/uL and < 1.5 x institutional upper limit of normal (ULN)
• Absolute neutrophil count > 1,500/uL
• Platelets > 100,000/uL * Patients on anticoagulation will still be eligible, and anti-coagulation will be handled in the same manner as other procedures performed within the department of interventional radiology
• Prothrombin time < 1.5 x ULN * Patients on anticoagulation will still be eligible, and anti-coagulation will be handled in the same manner as other procedures performed within the department of interventional radiology
• Partial thromboplastin time < 1.5 x institutional ULN
• Creatinine < 2.0 OR creatinine clearance >= 50 mL/min * Based on the standard Cockcroft and Gault formula (1976)

Exclusion Criteria

• Patients with Gleason grade group 1 or 2 prostate carcinoma (PCa) who select active surveillance as their cancer management method
• Receiving androgen deprivation therapy (ADT)
• Patients with unfavorable intermediate (Gleason grade group 3) or high risk localized PCa (Gleason grade groups 4 and 5)
• Receiving any investigational agents for the explicit purpose of prostatic size reduction
• Inability to receive PAE within 6-12 weeks of definitive XRT
• Active urinary tract infection (UTI)
• History of severe allergic reaction to intravenous contrast media (iodinated and gadolinium- based) or any agents used during the PAE; patient cannot be medicated against allergic reaction prior to PAE
• Active cystolithiasis or prostatitis
• Inability to multi-parametric magnetic resonance imaging (mpMRI)
• Prior transurethral prostatic resection (TURP) within 2 years
• Prostate size greater than or equal to 150 grams
• Vulnerable subjects (e.g., inmates and developmentally delayed adults) who are subjects for whom the study may be unsafe or whose rights may be violated with enrollment