Neoadjuvant Chemotherapy by Intra-Arterial Infusion for Osteosarcoma

Summary

Forty-seven patients with malignant bone and soft tissue tumors were treated with two kinds of intra-arterial infusion chemotherapy prior to surgery. These chemother-apeutic regimens were divided into two groups according to the infusional technique. Both techniques aimed to obtain a higher concentration of infused drug in the tumor tissue than conventional continuous intra-arterial infusion. Group A consisted of 35 cases, including 12 Osteosarcomas, treated with intra-arterial infusion under arterial blockade; group B consisted of 12 cases, including seven osteosarcomas, treated with balloon-occluded intra-arterial infusion (BOAI). The effect of preoperative chemotherapy was evaluated in the primary lesions of 22 patients with osteosarcoma. A better objective response was recognized in group B in all the monitored points. In clinical studies on cis-platinum (CDDP), it was also proved that BOAI is effective in administering the drugs at a higher concentration in the tumor tissue. It is believed that BOAI is a very useful technique for preoperative chemotherapy when planning limb salvage to obtain local control of the tumor.