恶性骨肿瘤术前动脉插管化疗栓塞的疗效探讨

Preoperative Treatment for Malignant Bone Tumor with Transarterial Infusion Chemo-embolization

目的:分析探讨恶性骨肿瘤术前行动脉插管化疗栓塞的价值。材料与方法:12例中,10例经活检病理证实为恶性骨肿瘤,2例结合患者既往病史及有关影像学资料诊断为骨转移瘤;12例病例在术前5至7天内均进行了动脉插管化疗,其中8例在超选择性动脉插管后,还进行了栓塞治疗。结果:全部患者的临床症状短时间内均有显著的改善,其中8例在插管后5至7天内进行了瘤段切除的保肢手术,另4例则行姑息切除术,手术后病理证实肿瘤均有不同程度的坏死、液化和囊变。结论:恶性骨肿瘤于术前进行动脉内化疗栓塞,能使肿瘤患者的临床症状短时间内得以明显改善,为进一步的手术治疗争取了时间及机会,同时有助于对术后病理的分析,指导术后化疗的实施。

Purpose: To study and evaluate the preoperative treatment for malignant bone tumor (MBT) with transarterial chemo-embolization. Materials and Methods: 10 cases were pathologically confirmed, including 5 osteosarcoma, 1 chondrosarcoma, 1 Ewing's tumor, 1 synovial sarcoma, 1 malignant fibrous histiocytoma and 1 leiomyosarcoma of bone. 2 rnetastatic carcinoma of bone were confirmed in combination with clinical data. Transarterial infusion chemotherapy (TAI) was performed for all patients and additional transarterial em-bolization (TAE) for 8 cases. Result: Relief of pain and decreased mass dimension was observed in all cases, but no severe complications occured. The tumors were resected and sent for pathological examination. All tumors had necrosis, liquefaction or cystic formation to variable extent. Conclusion: Preoperative treatment for MBT with transarterial infusion chemo-embolization can be considered as an effective therapeutical choice.