Clinicopathologic features and results of transcatheter arterial chemoembolization for osteosarcoma.
OBJECTIVE
To evaluate the effect of transcatheter arterial chemoembolization (TACE) for osteosarcoma and to describe the clinicopathologic features produced by TACE as well as the effect of different embolic materials.


METHODS
From January 1998 to December 2003, preoperative TACE was carried out in 32 patients. The preoperative and postoperative clinical response, levels of alkaline phosphatase (AKP), leukocyte count, and clinicopathologic features were recorded. We also compared the effect of different embolic materials: adriblastine gelatin microspheres, anhydrous alcohol, common bletilla tuber, and gelatin sponge particles.


RESULTS
The levels of AKP were significantly decreased after treatment (p < 0.05), but there was no significant difference in the leukocyte count. Large areas of necrosis were found histologically within 85.5% tumors after TACE. Embolic agents such as adriblastine microspheres, anhydrous alcohol, and common bletilla tuber have better clinical effects than gelatin sponge particles, but there was no significant difference among the first three embolic materials. After treatment, no serious complications were noted. During successful follow-up for 86 months, the survival rate after TACE at 1, 2, and 5 years was 95.5%, 72%, and 42% respectively.


CONCLUSIONS
TACE accelerated tumor necrosis and shrank the tumor volume, thus making adequate tumor resection possible. The optimal time to operate is 10-14 days after TACE. TACE in combination with limb salvage surgery and postoperative periodical chemotherapy may be beneficial for increasing local control rates.
Chu
Jian-Ping
JP
Department of Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Road 2nd, 510080, Guangzhou, People's Republic of China.
Chen
Wei
W
Li
Jia-Ping
JP
Zhuang
Wen-Quan
WQ
Huang
Yong-Hui
YH
Huang
Zhao-Min
ZM
Yang
Jian-Yong
JY
D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood / Q000187:drug effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D001859:Bone Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D002406:Catheterization, Peripheral; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005263:Femoral Artery; D005269:Femur / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000473:pathology; D007958:Leukocyte Count; D023821:Limb Salvage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D012516:Osteosarcoma / Q000097:blood / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D012720:Severity of Illness Index; D013977:Tibia / Q000473:pathology; D016896:Treatment Outcome; D047368:Tumor Burden / Q000187:drug effects
D014408:Biomarkers, Tumor; D015251:Epirubicin; D000469:Alkaline Phosphatase; D002945:Cisplatin; D008727:Methotrexate