転移性骨盤部骨腫瘍に対するSAP-MS（superabsorbent polymer microsphere）を用いた経カテーテル的動脈塞栓療法

Clinical Evaluation of Transcatheter Arterial Embolization with SAP-MS (Superabsorbent Polymer Microspheres) for Hypervascular Metastatic Bone Tumors of the Pelvis

　抄録：転移性骨盤部骨腫瘍症例6例に対し，疼痛緩和およびADL改善の目的で塞栓物質としてSAP-MSを用いて経カテーテル的動脈塞栓療法（TAE）を行い，その効果と安全性を検討した．4例は，TAEの前後に放射線療法，化学療法を併用した．全例に疼痛の軽減（平均232日間）およびADLが改善し，画像上もMRI T1強調画像（造影）にて腫瘍内部に壊死像が認められた．皮膚壊死など重篤な合併症は生じず安全に施行可能であった．TAEは，他に有効な治療法のない転移性骨盤部骨腫瘍症例にとって疼痛緩和およびADLの改善が得られる1つの有効な治療法と考えられた．

　Purpose：The purpose of this study was to evaluate the efficacy and safety of transcatheter embolization (TAE) with superabsorbent polymer microspheres (SAP-MS) of hypervascular metastatic bone tumors of the pelvis.

　Material ＆ Methods：SAP-MS are non-toxic calibrated microspheres that fluid, resulting in tight vessel occlusion. They were used for symptom palliation in six cases of malignant metastatic hypervascular bone tumors the in pelvis. Embolic effects were evaluated based on pain relief and its duration, and the presence of a necrotic area on MRI scans after TAE. In four cases radiation therapy and chemotherapy were used in combination before and after TAE.

　Results：Skeletal pain was relieved in all patients for a average of 8months. ADL in improved all patients as a result of pain relief after TAE, and contrast-enhanced T1-weighted MR images after TAE showed necrosis with the tumor.

　Conclusion：TAE with SAP-MS is an effective method of symptom palliation for hypervascular bone metastases in the pelvis.