[Intra-arterial high-dose adriamycin in patients with malignant bone or soft tissue tumors. The factors in poor...

Twenty-eight patients with malignant bone or soft tissue tumors were treated with preoperative and/or postoperative intra-arterial high-dose adriamycin. The antitumor effects of intra-arterial adriamycin were noted in not only primary tumor but also skip and distant metastasis (2 patients with lung metastasis). Clinical or histopathological responses were noted in 14/26 (54%) and 8/20 (40%) patients, respectively. Four patients were inoperable, but 24 patients were operable. Limb-saving procedures or amputation became subsequently feasible in 19/24 (79%) and 5/24 (21%) patients, respectively. Median follow-up of all the 28 patients was 23 months (minimum 3 months, maximum 127 months). Of the 20 patients with operable sarcomas, 11 (55%) were continuously disease-free, 3 (15%) were disease-free after treatment of a local recurrence or distant metastasis, and 5 (25%) died with multiple distant metastases. The Kaplan-Meier survival curves at 10 years showed 70% in 20 patients with operable sarcomas (66% in 8 with bone sarcomas, and 75% in 12 with soft tissue sarcomas). The initial large tumor size (greater than or equal to 10 cm diameters), poor response to intra-arterial adriamycin (less than NC* Clinically, less than II-B histopathologically), low total dose of adriamycin (less than 300 mg/m2), short total chemotherapy time (less than 6 months), and inadequate position of the tip of the catheter were the factors in poor prognosis.