Abstract
Purpose
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.
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References
Rowe DM, Becker GJ, Rabe FE et al (1984) Osseous metastases from renal cell carcinoma: embolization and surgery for restoration of function. Radiology 150:673–676
Sun S, Lang EV (1998) Bone metastases from renal cell carcinoma: preoperative embolization. J Vasc Interv Radiol 9:263–269
Wirbel RJ, Roth R, Schulte M et al (2005) Preoperative embolization in spinal and pelvic metastases. J Orthop Sci 210:253–257
Chatziioannou AN, Johnson ME, Pnermaticos SG et al (2000) Preoperative embolization of bone metastases from renal cell carcinoma. Eur Radiol 10:593–596
Nagata Y, Mitsumori M, Okajima K et al (1998) Transcatheter arterial embolization for malignant osseous and soft tissue sarcomas. II. Clinical results. Cardiovasc Intervent Radiol 21:208–213
Forauer AR, Kent E, Cwikiel W et al (2007) Selective palliative transcatheter embolization of bony metastases from renal cell carcinoma. Acta Oncol 46:1012–1018
Barton PP, Waneck RE, Karnel FJ et al (1996) Embolization of bone metastases. J Vasc Interv Radiol 7:81–88
Drooz AT, Lewis CA, Allen TE et al (2003) Quality improvement guidelines for percutaneous transcatheter embolization. J Vasc Interv Radiol 14:S237–S242
Chuang VP, Wallace S, Swanson D, Zoroza J, Handel SF et al (1979) Arterial occlusion in the management of pain from metastatic renal carcinoma. Radiology 133:611–614
Wallace S, Granmayeh M, DeSantos LA et al (1979) Arterial occlusion of pelvic bone tumors. Cancer 43:322–328
Uemura A, Fujimoto H, Yasuda S et al (2001) Transcatheter arterial embolization for bone metastases from hepatocellular carcinoma. Euro Radiol 11:1457–1462
Travis T, Monsky WL, London J et al (2008) Evaluation of short-term and long-term complications after emergent internal iliac artery embolization in patients with pelvic trauma. J Vasc Interv Radiol 19:840–847
Hare WS, Holland CJ (1983) Paresis following internal iliac artery embolization. Radiology 146:47–51
Park SI, Lee DY, Won JY, Lee JT (2003) Extrahepatic collateral supply of hepatocellular carcinoma by the intercostals arteries. J Vasc Interv Radiol 14:461–468
Arora R, Soulen MC, Haskal ZJ (1999) Cutaneous complications of hepatic chemoembolization via extrahepatic collaterals. J Vasc Interv Radiol 10:1351–1356
Miyayama S, Matsui O, Taki K et al (2006) Extrahepatic blood supply to hepatocellular carcinoma: angiographic demonstration and transcatheter arterial chemoembolization. Cardiovasc Intervent Radiol 29:39–48
Chiras J, Adem C, Calee JN et al (2004) Selective intra-arterial chemoembolization of pelvic and spine bone metastases. Eur Radiol 13:1774–1780
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Koike, Y., Takizawa, K., Ogawa, Y. et al. Transcatheter Arterial Chemoembolization (TACE) or Embolization (TAE) for Symptomatic Bone Metastases as a Palliative Treatment. Cardiovasc Intervent Radiol 34, 793–801 (2011). https://doi.org/10.1007/s00270-010-0031-8
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DOI: https://doi.org/10.1007/s00270-010-0031-8