Bridwell K H
Division of Orthopedic Surgery, Barnes Hospital, Washington University School of Medicine, St. Louis, Missouri.
Urol Clin North Am. 1991 Feb;18(1):153-9.
There is a wide spectrum of presentations for prostate cancer metastatic to the spine. Important factors are the patient's age and general health; the extent and location of spinal involvement; the patient's neurologic status and degree of pain; the relative contribution of a blastic or lytic response; and the experience and training of the spinal surgeon, medical oncologist, and radiation oncologist. The spine is both a weight-bearing structure and a housing for the spinal cord, and failure to consider both functions may lead to unsatisfactory treatment results. Treatment options include hormonal therapy, inhibitors of bone metabolism, glucocorticoid therapy, radiotherapy, halo-vest, surgical debridement, decompression and stabilization, and appropriate pain management and support. One must not lose sight of the fact that the goals are palliation and that ultimate demise is unavoidable in patients with metastatic prostate cancer.
前列腺癌转移至脊柱有多种表现形式。重要因素包括患者的年龄和总体健康状况；脊柱受累的范围和部位；患者的神经状态和疼痛程度；成骨或溶骨反应的相对作用；以及脊柱外科医生、医学肿瘤学家和放射肿瘤学家的经验和培训。脊柱既是承重结构，又是脊髓的容纳部位，未能兼顾这两种功能可能导致治疗效果不理想。治疗选择包括激素治疗、骨代谢抑制剂、糖皮质激素治疗、放疗、头环背心、手术清创、减压和稳定，以及适当的疼痛管理和支持。必须牢记，目标是缓解症状，对于转移性前列腺癌患者来说，最终死亡是不可避免的。
