骨与软组织恶性肿瘤的介入治疗

Interventional Therapy of Malignant Bone and Soft-tissue Tumors

目的 探讨骨与软组织恶性肿瘤局部动脉内灌注化疗 (TAI)和栓塞 (TAE)的临床价值。资料与方法 12 8例 (14 9次 )均采用Seldinger技术经皮穿刺股动脉插入Cobra导管至肿瘤局部动脉内。 12 8例均进行TAI,10 4例并用TAE。结果 TAI和 /或TAE后 10 7例疼痛缓解或消失 ;98例软组织消肿 ,肿瘤缩小 ;10 3例在介入治疗后 1周内又接受手术治疗并经病理检查 ,显示瘤细胞不同程度变性、坏死、液化 ,以并用TAE者更为显著。肢体肿瘤患者71.9% (4 1/ 5 7)行保肢手术。结论 TAI和 /或TAE对骨与软组织恶性肿瘤具有显著疗效 ,TAE较TAI疗效更为显著 ,肿瘤供养血管超选择插管是提高疗效、减少并发症的关键。

Objective To in vestigate the value of transarterial infusion chemotherapy (TAI) and embolization (TAE) in the treatment of malignant bone and soft tissue tumors. Materials and Methods TAI was performed in all 128 patients using a cobra catheter via femoral artery by Seldinger's technique and additional TAE in 104 patients. The technique of selective catheterization, curative effect were analyzed retrospectively. Results After TAI and/or TAE, the pain of 107 patients was alleviated or relieved, and soft tissue swelling and tumor size of 98 patients were reduced. 103 patients underwent surgical resection 1 week after interventional treatment. Tumor resected appeared degeneration, necrosis, liquefaction to various extent by pathology, especially following additional TAE. Limp sparing resection was obtained in 71.9% (41/57) patients. Conclusion TAI and/or TAE are highly effective in the treatment of malignant bone and soft tissue tumor, but TAE was superior to TAI alone in curative effects. Superselective catheterization for feeding arteries of tumors is the key to improvement of the curative effect and the complication.