The Efficiency Of TACE In Treatment Of Bone And Soft Tissue Sarcoma

PartⅠEvaluating the efficiency of TACE in treatment of patients with Bone and Soft Tissue sarcomaObjective: Transaterial chemoembolization(TACE) was used in the treatment of carcinomas, and most prominently for hepatic neoplasms. However, its efficiency in the treatment of advanced bone and soft tissue sarcoma remains to be determined. The study aim was to evaluate the efficiency of TACE in the treatment of bone and soft tissue sarcomas and its associated factors affecting patient survival.Methods and Materials: Between 2009 to 2011, 39 patients with bone and soft tissue sarcomas received TACE as a primary treatment. In the follow-up post treatment, survival was deemed as the primary end point. The survival rates were calculated using the Kaplan-Meier method. The multivariate analyses for the factors affecting survival were evaluated by the Cox proportional hazard model. Results: The mean follow-up and survival period following TACE was 24 months. Specifically, the 1-year, 2-year, and 3-year survival rates were 71.5%, 45.8%, and 32.5%, respectively. Tumour size, number of lesions, response of treatment on imaging, and tumor stage were identified as key predictors of survival. TACE therapy was found to improve the relapse interval. Furthermore, polyvinyl alcohol(PVA) particle diameter(p=0.03) and imaging response(p=0.044) were identified as the factors affecting the relapse interval. No significant TACE-related complications or TACE-related deaths were observed.Conclusion: TACE is an effective therapeutic method for advanced bone and soft sarcomas. Multiple lesions and tumor stage were found to be independent risk factors for patient survival. Although TACE treatment was not effective in improving overall survival, it increased the duration of relapse interval.Part ⅡThe comparion study between two methods in building of soft tissue sarcomaObjective: the aim of this study is to compare the efficiency between two methods,percutaneous implantation and open-surgery implantation,in building of soft tissue sarcoma,and demonstrate the best time for therapy.Methods and materials:twenty white rabbits were random divided into group Ⅰ and group Ⅱ,each group has ten rabbits.two methods including pecutaneous implantation and open-surgery implantation was applied to establish tumor model,follow-up was performed in 10, 15, 20, 25, 30 days using MRI respectively,The mean implantation time and the volume of tumor was compared between two groups using wilcoxon signed-rank test.The Kaplan-Meier method with log rank test was used to compare the Survival time of two groups.the necrosis was examined by hematoxylin-eosin staining along with MRI.Results:all rabbit tumor model were succesfully build and no operation related mortality occurred. The mean implantation time of group was obvious shorter than group Ⅰ Ⅱ(p<0.001).The rabbit numbers with mutiple lessions in group were twice more than group Ⅰ Ⅱ,but the difference showed no statistical significance(p=0.089).The tumor diameter in 10 days,15 days,20 days,25 days and 30 days between two groups had no difference(p>0.05).The mean survival time evaluated by Kaplan-Meier method and tested by log-rank were demonstrated has no statistical significance(p=0.12).Conclusion: Both percutaneous implantation and open-surgery implantation was an effective methods to establish VX2 tumor model with high successful growth rate, though consuming time in group Ⅰwas shorter than group Ⅱ but open-surgery implantation was suggested to establishing an animal model,because open-surgery implantation was more suitable to study for group had larger tumor diameter and less tumor lessionsⅡ compared to group Ⅰ.the most optical therapy time was 15-20 days.Part Ⅲ Evaluating the efficiency of TACE in treatment of rabbit model with Bone and Soft Tissue sarcomaObjective:The aim of study was to evaluate the effective of various PVA diameter in treatment of rabbit soft tissue sarcoma model.metohds and Materials:20 rabbits was used in building VX2 animal model,the target tissue was thigh muscle.TACE was performed at 19 and 20 days.20 rabbits with soft tissue sarcoma was divided into two groups :group Ⅰand group Ⅱ.group Ⅰwas treated by TACE with 100 um PVA,on the contrary,group was treated by TACE with 300 um PVA.MRI was completed at 7 Ⅱdays following TACE,and all rabbits was killed and tumor was harvested after MRI scan.Results:The rabbits VX2 model was successfully built and TACE was performed in all twenty rabbits.there was no operation related mortality occurred.the numbers in group with imaging response were more than group Ⅰ Ⅱ,but it has no statistical significance(p=0.329).The numbers of feeding artery containing PVA in group Ⅰwere more than group Ⅱ,and the gaps has statistical significance(p=0.029).The mean diameter of feeding artery containing PVA in group Ⅰwas smaller than group Ⅱ(p=0.015).Conclusion:TACE was an effective in treatment of soft tissue sarcoma,and smaller PVA diameter was suggested in treatment of soft tissue sarcoma for it has slightly more tumor necrosis and more feeding artery occlusion rate.