Jiang Chunyu, Wang Jianbo, Wang Yonggang, Zhao Jungong, Zhu Yueqi, Ma Xu, Zhou Jia, Yan Xuebing
Department of Radiology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, 600 Yi-Shan Road, Shanghai, 200233, People's Republic of China.
Department of Oncology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China.
Cardiovasc Intervent Radiol. 2016 Oct;39(10):1420-8. doi: 10.1007/s00270-016-1399-x. Epub 2016 Jun 22.
Transarterial chemoembolization (TACE) is used to treat unresectable bone and soft tissue sarcoma (STS) and as a pre-surgical adjuvant treatment. However, its efficiency for advanced STS is undetermined. This study evaluated TACE's efficiency in treating advanced STS and prognostic factors for patient survival.
We enrolled 39 patients with unresectable STS who underwent TACE as an alternative treatment during 2010-2014, with overall survival (OS) as the primary end point. Cancer pain was evaluated by visual analogue scores (VAS) before and after TACE procedures. Factors that affect survival were evaluated by multivariate analyses (Cox proportional hazard model).
Mean OS after TACE was 23.7 ± 2.1 months, with 1-year OS 71.5 %, 2-year OS 45.8 %, and 3-year OS 32.5 %. Lesion number and tumor stage were key predictors of survival. TACE was found to decrease cancer pain VAS and increase relapse interval. Size of polyvinyl alcohol (PVA) particle diameter (P = 0.03) and imaging response (P = 0.044) were also found to affect relapse interval.
TACE was an effective treatment for advanced STS, with a 32.5 % 3-year OS rate, and led to lower cancer pain VAS and longer relapse intervals than chemoinfusion only. Smaller PVA particles are preferable during the TACE procedure.
经动脉化疗栓塞术（TACE）用于治疗无法切除的骨肉瘤和软组织肉瘤（STS），并作为术前辅助治疗。然而，其对晚期STS的疗效尚未确定。本研究评估了TACE治疗晚期STS的疗效及患者生存的预后因素。
我们纳入了39例无法切除的STS患者，这些患者在2010 - 2014年期间接受TACE作为替代治疗，以总生存期（OS）作为主要终点。在TACE手术前后通过视觉模拟评分（VAS）评估癌痛情况。通过多因素分析（Cox比例风险模型）评估影响生存的因素。
TACE后的平均OS为23.7±2.1个月，1年OS为71.5%，2年OS为45.8%，3年OS为32.5%。病灶数量和肿瘤分期是生存的关键预测因素。发现TACE可降低癌痛VAS并延长复发间隔。还发现聚乙烯醇（PVA）颗粒直径大小（P = 0.03）和影像学反应（P = 0.044）会影响复发间隔。
TACE是治疗晚期STS的有效方法，3年OS率为32.5%，与单纯化疗灌注相比，可降低癌痛VAS并延长复发间隔。在TACE手术过程中，较小的PVA颗粒更佳。
