Effects observation of subcutaneous intra-arterial chemotherapy with subcutaneously implanted pump for extremity soft tissues sarcoma and cancerous ulcer
LIU Cheng
LI Ding-feng
CUI Qiu
GUO Jun
Abstract：Objective To observe the efficiency of subcutaneous intra-arterial chemotherapy with subcutaneously implanted pump for extremity soft tissues sarcoma and cancerous ulcer.Methods Thirty-one patients with ulcerative skin squamous cell carcinoma or soft tissues sarcoma of extremities received treatment from July 2003 to November 2011,including 15 males and 16 females.The average age was 49 years old ( range: 14-83 years ).Ten patients had sarcoma in upper extremities and 21 patients in lower extremities.The pathological types of studied cases included 9 cases with skin squamous cell carcinoma,6 cases with synovial sarcoma,5 cases with malignant fibrous histiocytoma,3 cases with liposarcoma,3 cases with osteosarcoma,2 cases with malignant melanoma,2 cases with epidermoid sarcoma,and 1 case with protuberans.The main symptoms of cancerous ulcer were pain,infection and hemorrhage.All the studied patients were administrated with cisplatin ( 120 mg / m2 ) and doxorubicin ( 90 mg / m2 ) by intra-arterial chemotherapy pump,and the patients with squamous cell carcinoma were additionally applied with bleomycin ( 15 mg ) and patients with malignant melanoma were applied with dacarbazine ( 600 mg / m2 ).The chemotherapy efifciency was observed after at 2-3 cycles of intra-arterial chemotherapy.Surgical or conservative treatment was chosen according to tumor boundary and blood supply after chemotherapy.Pain and pain relief were observed in patients pre-treatment and post-treatment.Effects on solid tumors were evaluated according to WHO ( World Hearth Organization ) criteria.Results The mean follow-up was 67 months in this group.( 1 ) Before the treatment,moderate pain was in 18 cases,severe pain in 13 cases.Pain relief was achieved after one cycle of chemotherapy,including complete remission ( CR ) 19 cases,partial remission ( PR ) 8 cases,mild remission ( MR ) 4 cases.The total remission rate of pain ( RR ) was 87％.There were only four cases of mild pain after three times of chemotherapy.( 2 ) Immunity was decreased due to the ulcers in patients.Tumor ulcer patients after chemotherapy: CR 7 cases,PR 15 cases,NC ( no curative effect ) NC 9 cases.Total remission rate of ulcer cicatrization ( RR ) was 71％.Stench from tumor ulceration occurred in 12 cases,all oozing and stench reduced post-treatment.Featured with ulceration and hemorrhage,hemostasis in 6 cases was achieved after 3-4 times of chemotherapy.In 11 cases of patients with lymph node metastasis,lymph node metastases disappeared in 8cases and reduced in size in 3 cases signiifcantly after chemotherapy.( 3 ) Except for malnourished skin comparing with the healthy side,no other adverse side effects existed.After tumor shrinking in chemotherapy,surgeries were performed in 19 cases ( 16 cases of limb salvage,3 cases of amputation ),and the remaining 12 cases were treated conservatively.Three out of 16 patients had local recurrence ( 19％).Postoperative pathologic response to chemotherapy occurred in 5 patients ( mild ),10 patients ( moderate ) and 4 cases ( severe ).Conclusions The subcutaneous intra-arterial targeting chemotherapy can be applied to treat extremities sarcoma and cancerous ulcer to signiifcantly increase the chemotherapeutic concentration at tumor area so as to effectively constrain the tumor rupture induced main symptoms including pain,infection and bleeding,which will help to make a decreased blood supplied and well deifned tumor boundary to ifnally decrease the recurrence rate.
Keywords：SarcomaUlcerPathologic processesCarcinomabasal cellChemoradiotherapyUlcer carcinoma
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 361-365 )