title: Transcatheter arterial chemoembolization (TACE) or embolization (TAE) for symptomatic bone metastases as a palliative treatment.
abstract: OBJECTIVE
  This study was designed to evaluate the effect of transcatheter arterial chemoembolization (TACE)/embolization (TAE) for symptomatic bone metastases especially in palliation.
  
  
  METHODS
  Between April 2006 and December 2009, 24 bone metastatic lesions of 18 patients (8 women and 10 men; mean age, 64 years) underwent palliative TACE or TAE. A total of 40 sessions were performed, with 1-4 sessions per lesion. The primary lesions included hepatocellular carcinoma, colorectal cancer, renal cell cancer, ovarian cancer, thyroid cancer, uterine cervical cancer, and esophageal cancer. Symptomatic lesions involved thoracic spine, lumbar spine, pelvis, rib, and femur. The procedures were performed with a coaxial catheter technique to catheterize selectively target arteries. If not possible due to small branches, blood flow alteration by coil was achieved. Gelatin sponge was the initial embolic materials. As anti-cancer agents, epirubicin, fluorouracil, and mitomycin were mainly used in consideration for primary lesion and past treatment.
  
  
  RESULTS
  Sufficient devascularization of targeted lesions was obtained in 18 of 24 (75%) lesions without any serious complication. Pain relief was obtained in 20 lesions (83%), with significantly decrease in the visual analogue scale score (P < 0.001). A relationship was found between the devascularization grade and pain relief (r = 0.49, P < 0.05). Follow-up CT images at 1 month of nine lesions (50%) revealed necrotic change in the tumors.
  
  
  CONCLUSIONS
  Palliative TACE/TAE for symptomatic bone metastases could be a suitable treatment method because it is minimally invasive, repeatable, effective, and rapid-acting.
authors.affiliation: Department of Radiology, St Marianna University School of Medicine, 2-16-1, Sugao, Miyamae, Kawasaki, Kanagawa 216-8511, Japan. r06118@hotmail.co.jp
authors.forename: Yuya
authors.initials: Y
authors.lastname: Koike
authors.forename: Kenji
authors.initials: K
authors.lastname: Takizawa
authors.forename: Yukihisa
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Ayako
authors.initials: A
authors.lastname: Muto
authors.forename: Misako
authors.initials: M
authors.lastname: Yoshimatsu
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yagihashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography; D001859:Bone Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D014057:Tomography, X-Ray Computed