Gasbarrini A, Cappuccio M, Mirabile L, Bandiera S, Terzi S, Barbanti Bròdano G, Boriani S
Department of Orthopaedics and Traumatology, Maggiore Hospital "C.A. Pizzardi", Bologna, Italy.
Eur Rev Med Pharmacol Sci. 2004 Nov-Dec;8(6):265-74.
Spinal metastases are only apparently similar lesions, considering the large varieties of istotypes and the spread of the primary tumor. These metastases develop early and are not terminal events, they have to be considered as severe complications because, when possible, surgical treatment can improve the history of the patient in terms of life expectancy and quality of life. The approach to these lesions should be multidisciplinary in collaboration with oncologists and radiotherapists, in fact the average of survival of these patients has increased in recent years. The evolution of anesthaesiological techniques that permit surgical treatments that were once considered prohibitive. The application of new adjuvant therapy increases the effectiveness for surgical treatment. Controversy exist over the most appropriate treatment for patients with metastatic disease of the vertebral column. The purpose of this article was to determine the best sequential process to arrive at the most appropriate treatment considering the individual general conditions and the parameters of the metastases. We review 269 cases in 182 patients suffering from spinal metastases from a solid tumour treated between 1996 and 2002. As the number of treatment options for metastatic spinal disease has grown, it has become clear that effective implementation of these treatments can only be achieved by multidisciplinary approach.
考虑到脊柱转移瘤的多种组织学类型和原发肿瘤的扩散情况，它们只是表面上相似的病变。这些转移瘤发展较早，并非终末期事件，必须将其视为严重并发症，因为在可能的情况下，手术治疗可以在预期寿命和生活质量方面改善患者的病程。对于这些病变的治疗方法应该是与肿瘤学家和放射治疗师合作采取多学科方法，事实上，近年来这些患者的平均生存期有所增加。麻醉技术的发展使得曾经被认为禁忌的手术治疗成为可能。新辅助治疗的应用提高了手术治疗的效果。对于脊柱转移性疾病患者的最合适治疗方法存在争议。本文的目的是确定在考虑个体一般状况和转移瘤参数的情况下，达成最合适治疗的最佳连续过程。我们回顾了1996年至2002年间接受治疗的182例患有实体瘤脊柱转移瘤患者的269个病例。随着转移性脊柱疾病治疗选择数量的增加，很明显只有通过多学科方法才能有效实施这些治疗。
