TRANSCATHETER ARTERIAL EMBOLIZATION FOR MALIGNANT OSSEOUS AND SOFT-TISSUE SARCOMAS - II - CLINICAL-RESULTS

Purpose: To evaluate the clinical effects of transcatheter arterial em bolization (TAE) on malignant bone and soft tissue tumors. Methods: TA E was performed in 10 patients with primary bone and soft tissue sarco mas and in 31 patients with metastatic bone tumors. The embolized arte ries were the internal iliac artery in 30 cases, the Intercostal arter y in six cases, the lumbar artery in five cases, the suprascapular art ery in three cases, and the iliolumbar artery, the internal pudendal a rtery, and the lateral sacral artery in one case each, The embolized m aterial was gelatin sponge particles. The chemotherapeutic drugs were usually 20-40 mg of doxorubicin for primary and metastatic tumors and 50-100 mg of cisplatin only for primary tumors. In addition, 50-60 Gy of 10-MV radiotherapy with or without radiofrequency (RF)-capacitive h yperthermia in four sessions was administered before TAE for primary t umors only. Results: Even though the pain score increased immediately after TAE, 30 of 38 (79%) patients with pain (8 of 9 with primary tumo rs, and 22 of 29 with metastases) achieved pain control after TAE. A n ecrotic low-density area shown by computed tomography (CT) after TAE w as found in 31 of 41 (76%) tumors [8 of 10 (80%) with primary tumors, and 23 of 31 (74%) with metastatic tumors]. The tumor size decreased i n 14 of 25 (56%) primary and metastatic tumors after 3 months. Osteosc lerotic changes appeared in two cases of metastatic tumors after 6 mon ths. In five tumors resected after TAE, large areas of necrosis within the tumor were confirmed histologically. Transient local pain and num bness appeared after TAE, but were relieved by drug treatment within 1 week. No severe complications except a case of gluteal muscle necrosi s were encountered after TAE. The I-year survival rate of the patients with primary tumors was 38.1%, and the median survival was 18 months. The longest survival was 84 months. The 1-year survival rate of the p atients with metastatic bone tumors was 38.9%; the median survival was 12 months. The longest Survival was 24 months. Conclusion: TAE could be an effective treatment for pain control and local control of malign ant bone and soft-tissue tumors.