The Journal of the Korean bone and joint tumor society (대한골관절종양학회지)

The Korean Musculoskeletal Tumor Society (대한근골격종양학회)
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Analysis for Usefulness of Arterial Embolization on Sacral and Pelvic Giant Cell Tumors

천골 및 골반골에 발생한 거대세포종에 대한 동맥 색전술 치료의 효용성 분석

  • Kim, Seung Hyun (Department of Orthopedic Surgery, Yonsei University College of Medicine) ;
  • Yoon, Gil Sung (Department of Orthopedic Surgery, Yonsei University College of Medicine) ;
  • Cho, Yong Jin (Department of Orthopedic Surgery, Yonsei University College of Medicine) ;
  • Shin, Kyoo-Ho (Department of Orthopedic Surgery, Yonsei University College of Medicine) ;
  • Suh, Jin-Suck (Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine) ;
  • Yang, Woo-Ick (Department of Pathology, Yonsei University College of Medicine)
  • 김승현 (연세대학교 의과대학 정형외과) ;
  • 윤길성 (연세대학교 의과대학 정형외과) ;
  • 조용진 (연세대학교 의과대학 정형외과) ;
  • 신규호 (연세대학교 의과대학 정형외과) ;
  • 서진석 (연세대학교 의과대학 영상의학과) ;
  • 양우익 (연세대학교 의과대학 병리학과)
  • Received : 2013.11.01
  • Accepted : 2013.11.26
  • Published : 2013.12.31
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Abstract

Purpose: The purpose of this study is to determine the usefulness of arterial embolization on sacral and pelvic giant cell tumor (GCT). Materials and Methods: We retrospectively reviewed the medical records of 9 patients who had undergone serial arterial embolization between December 1996 and May 2008. We analyzed the clinical outcomes and therapeutic responsiveness of arterial embolization on sacral and pelvic GCT. Results: Six of 9 cases showed progression of disease (PD) status, even if 5 cases showed PD status despite of additional treatments including surgery and radiation, implying that serial arterial embolization on sacral and pelvic GCT is not effective. Three of 9 cases showed stable disease (SD) or continuous disease free (CDF) status and we analyzed associated factors with these good responses for embolization by ${\chi}^2$ test. The number of feeding vessels under six (p=0.048) and the number of collateral arterial supply under three (p=0.048) in the first angiogram showed significant relationships with good response for embolization, while remaining tumor staining by contrast after the first embolization and repeated embolization times were not significant. Conclusion: Although serial arterial embolization is not an effective modality on sacral and pelvic giant cell tumors, it may be a pilot modality under narrow indication of tumors with poor vascularity at first angiogram.

목적: 천골 및 골반골에 발생한 거대세포종에 대한 동맥 색전술의 효용성을 규명하고자 하였다. 대상 및 방법: 1996년 12월부터 2008년 5월까지 연속적 동맥 색전술을 시행한 9예를 대상으로 그 임상 결과 및 동맥 색전술에 대한 거대세포종의 치료 반응성을 후향적으로 분석하였다. 결과: 9예 중 6예에서 거대세포종이 진행되어 연속적 동맥 색전술은 천골 및 골반골 거대세포종 치료에 있어서 효과적인 치료 방법은 아닌 것으로 나타났다. 5예의 경우에서는 수술, 방사선 치료 등의 추가적인 치료를 시행 했음에도 불구하고 거대세포종이 진행되었다. 9예 중 3예에서 거대세포종의 호전 및 완치 소견을 보여, 카이제곱 검정을 통해 이와 관련된 인자들에 대해 분석하였다. 첫 혈관조영술 시행 시 거대세포 종양의 영양 혈관수가 6개 미만인 경우(p=0.048), 측부 순환의 개수가 3개 미만인 경우(p=0.048) 만이 동맥 색전술에 대한 치료 반응성과 연관이 있는 것으로 나타났으며, 첫 동맥 색전술 시행 후 잔존 종양 염색 유무와 반복 시행 횟수는 연관이 없었다. 결론: 천골 및 골반골 거대세포종의 치료에 있어서 연속적 동맥 색전술은 일반적으로 사용될 수 있는 효과적인 치료 방법은 아니나, 첫 혈관 조영술 시행 시 종양의 혈관 분포가 적은 경우에 한해서 시행한 다면 좋은 치료 결과를 기대할 수 있다.

Keywords

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