Neoadjuvant intraarterial chemotherapy sarcomas of limbs and pelvis

Summary. Оsteosarcoma is most frequently among the primary malignant tumors of bones skeleton. The disease occurs mainly in children and young people. More than half of the observation process is localized in the bones that form the knee joint. The high frequency of recurrence and the likelihood of hematogenous metastasis reguires to use the neoadjuvant chemotherapy. There are intravenous and regional intraarterial infusions of cytotoxic drugs. The use of intraarterial infusion chemotherapy techniques has several advantages: allows you to create long-enduring concentration of cytotoxic agents in the area of the tumor destruction; provide direct contact and absorption of cytotoxic drugs with tumor cells at all stages of the cell cycle; early citoreductive chemotherapy can reduce the risk of chemoresistent and, as a consequence, the development of metastatic disease; direct local clinical effect is achieved immediately; additional effects of drugs administered is significantly reduced. The purpose of the study is to develop a new approach in the appointment of neoadjuvant chemotherapy for patients with sarcomas of bone in order to predict the histological tumor response and individualized the duration of chemotherapy. The therapeutic pathomorphosis of tumors was evaluated on the basis of the level of inhibition the neovascularization, a registered during serial angiographic studies.