Gupta Pankaj, Gamanagatti Shivanand
Pankaj Gupta, Shivanand Gamanagatti, Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
World J Radiol. 2012 May 28;4(5):186-92. doi: 10.4329/wjr.v4.i5.186.
Bone tumors include a variety of lesions, both primary and metastatic. The treatment modalities for bone tumors vary with the individual lesion, but in general surgical excision is the treatment of choice with other adjunctive therapies. However, surgery for many bone tumors is complex due to several factors including tumor bulk, vascularity, vicinity to vital structures and potentially inaccessible location of the lesion. Transarterial Embolisation (TAE) is one of the important adjuvant treatment modalities and in some cases it may be the primary and curative treatment. Preoperative TAE has proved to be effective in both primary and metastatic bone tumors. It reduces tumor vascularity and intraoperative blood loss, the need for blood transfusion and associated complications, allows better definition of tissue planes at surgery affording more complete excision, and hence reduced recurrence. Preoperative chemoEmbolisation has also been shown to increase the sensitivity of some tumors to subsequent chemotherapy and radiotherapy. There are several techniques and embolic agents available for this purpose, but the ultimate aim is to achieve tumor devascularization. In this review, we discuss the techniques including the choice of embolic agent, application to individual lesions and potential complications.
骨肿瘤包括多种原发性和转移性病变。骨肿瘤的治疗方式因个体病变而异，但一般来说，手术切除是主要治疗方法，并辅以其他治疗。然而，由于多种因素，包括肿瘤大小、血管分布、与重要结构的毗邻关系以及病变可能难以到达的位置，许多骨肿瘤的手术都很复杂。经动脉栓塞术（TAE）是重要的辅助治疗方式之一，在某些情况下可能是主要的根治性治疗方法。术前TAE已被证明在原发性和转移性骨肿瘤中均有效。它可减少肿瘤血管供应和术中失血、输血需求及相关并发症，使手术时组织层面更清晰，从而能更完整地切除肿瘤，进而降低复发率。术前化疗栓塞也已显示可提高某些肿瘤对后续化疗和放疗的敏感性。为此有多种技术和栓塞剂可供选择，但最终目的是实现肿瘤去血管化。在本综述中，我们将讨论相关技术，包括栓塞剂的选择、应用于个体病变以及潜在并发症。
