Selective intra-arterial chemoembolization of pelvic and spine bone metastases.
The purpose of this study was to determine the effect of interventional palliative therapy by using chemoembolization on metastatic bone pain and tumor bulk in inoperable metastases where chemotherapy and radiotherapy had failed. Twenty-five patients (mean age: 59 years) underwent chemoembolization of symptomatic lytic lesions involving the spinal column (n=10), iliac bone and sacrum (n=15). The study design consisted of at least three procedures based on combined chemoembolization performed under analog-sedation. Therapeutic agents were carboplatin for selective chemotherapy and pirarubicin mixed with polyvinyl alcohol foam for chemoembolization. Fifteen of 18 (83%) patients had significant pain relief, as shown by the decrease of analgesic drug use. Mean clinical response duration was 12 months. Radiologically, ten patients were stable. A partial response was observed in four patients, while a complete response was seen in two others. Selective intra-arterial chemoembolization gives longer pain relief than embolization, compared to the literature data, probably because of partial response with local anti-cancer drugs.
Chiras
Jacques
J
Department of Neuroradiology, Groupe Hospitalier Pitié-Salpêtrière, 47, boulevard de l'Hôpital, Paris, France. jacques.chiras@psl.ap-hop-paris.fr
Adem
Carmen
C
Vallée
Jean-Noël
JN
Spelle
Laurent
L
Cormier
Evelyne
E
Rose
Michèle
M
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001859:Bone Neoplasms / Q000556:secondary* / Q000628:therapy; D016190:Carboplatin / Q000008:administration & dosage; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000473:pathology; D007261:Infusions, Intra-Arterial; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010166:Palliative Care; D010384:Pelvic Bones / Q000473:pathology*; D011142:Polyvinyl Alcohol / Q000008:administration & dosage; D012447:Sacrum / Q000473:pathology; D013125:Spinal Neoplasms / Q000556:secondary* / Q000628:therapy; D013904:Thoracic Vertebrae / Q000473:pathology
D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D004317:Doxorubicin; D011142:Polyvinyl Alcohol; D016190:Carboplatin; C027260:pirarubicin