[Intraarterial high-dose adriamycin for patients with skeletal or soft tissue sarcoma]

In this paper, we summerized our experience with intraarterial high-dose adriamycin for thirteen patients with skeletal or soft tissue sarcoma. Eight patients had skeletal sarcoma and five had soft tissue sarcoma. Anticancer agents delivered intermittently an intra-arterial catheter (percutaneous placement by Sledinger technique) over 30 minutes. The compound of 1 mg of vincristine, 3 mg of Carboquone and 600 mg of dextran sulfate sodium was given weekly from the time of biopsy. Adriamycin was given at a dose of 0.8 mg/kg/day for 3 days after histological examination revealed sarcoma. Just prior to the adriamycin infusion, compound of 18,000 units of urokinase and 600 mg of dextran sulfate sodium was infused by bolous method. Course of therapy were repeated at every 3 to 4 weeks intervals. Surgical procedures were performed following completion of one to three courses of therapy. Total of 24 courses of therapy performed to 13 patients. Twelve patients had 20 courses preoperatively had three patients had 4 courses postoperatively. The overall objective clinical response rate (complete or partial response) by a combination of computed tomography and physical examination was 7/12 (58.3%). The overall histological response rate (greater than 75% tumor cell necrosis) was 4/9 (44.4%). During the period of follow up, with ranged from 2 to 60 months, none had local recurrence in the group performed radical operation (6 limb salvage procedures and 4 primary amputation). In this group one patient had lung metastases. The overall disease free survival rate was 8/10 (80.0%). In pharmacologic data from our series, adriamycin levels in venous blood adjacent to the arterially infused area were always higher than those from simultaneously sampled peripheral venous blood. Furthermore, peripheral blood levels of adriamycin following administration by the intraarterial route were not different from those obtained when the same dose is given intravenously. Our results of intraarterial high-dose adriamycin lend support and rationale to the use of regional intraarterial therapy even in patients with pulmonary metastasis. The latter will be exposed to a drug concentration expected from intravenous administration while the patient may also benefit from the augmented local effect.