介入栓塞化疗联合索拉非尼治疗肢体腺泡状软组织肉瘤9例分析

Interventional therapy plus sorafenib in patients with limbs alveolar soft tissue sarcoma:a report of 9 cases

目的探讨介入联合索拉非尼治疗肢体腺泡状软组织肉瘤的有效性与安全性。方法回顾性分析2007年7月至2010年7月就诊于复旦大学附属肿瘤医院的9例晚期腺泡状软组织肉瘤病人的临床资料。9例病人予以动脉介入栓塞化疗联合索拉非尼治疗,分析其有效性与安全性,了解其预后情况。结果经介入栓塞化疗及索拉非尼治疗后,MRI随访显示肢体原发病灶均无明显缩小,但病灶坏死液化明显,主观症状改善,表现为疼痛的缓解或止痛药的减量,行走障碍或肢体活动障碍得到缓解。肺及肝内转移病人转移病灶能得到有效控制,咯血、紫绀症状得到明显缓解,户外活动量增加。多发骨转移病人疼痛症状无明显改善,仍需止痛药维持治疗。所有病人均未出现与介入栓塞化疗及索拉非尼相关的严重不良反应,无需调整剂量或中断治疗。结论介入联合索拉非尼治疗,可显著改善晚期腺泡状肉瘤病人肿瘤局部症状及肿瘤相关并发症,明显提高生活质量,短期生存获益好,可作为晚期腺泡状肉瘤治疗的重要补充。

Objective To evaluate the efficacy and safety of interventional therapy combined with sorafenib in patients with limbs alveolar soft tissue sarcoma. Methods The clinical data of 9 cases of advanced limbs alveolar soft tissue sarcoma admitted between July 2007 and July 2010 in Fudan University Shanghai Cancer Center were analyzed retrospectively. All cases were obtained artery interventional embolism chemotherapy combined with sorafenib therapy. The efficacy, safety and prognosis survival situation were analyzed. Results After interventional embolism chemotherapy and sorafenib therapy, limbs primary lesions were not reduced significantly by MRI follow-up. But focal necrosis liquefied obviously and subjective symptoms improved including the pain relief or painkillers decrement, walking disorder or body activities obstacles eased. For the patients with lung or liver metastasis, the metastatic lesions got effective control, haemoptysis and cyanosis symptoms were alleviated obviously, and outdoor activities were increased. For the patients with muhiple bone metastases, the bone pain symptoms have no obvious relief, and painkillers were still need to maintenance therapy. No serious adverse reaction related to interventional embolism chemotherapy and sorafenib therapy was observed in all patients, which needn＇t adjustment of dose or interrupt treatment. Conclusion Interventional therapy combined with sorafenib therapy can relieve the tumor local symptoms and tumor related complications, improve quality of life significantly in patients with advanced limbs alveolar soft tissue sarcoma. The short-term survival benefit is good. It can be used as important supplement of the treatment for advanced limbs alveolar soft tissue sarcoma.