Sugiura Hideshi
Department of Orthopedic Surgery, Aichi Cancer Center Hospital.
Clin Calcium. 2011 Mar;21(3):439-45.
Bone metastasis from lung cancer requires a thorough examination of bones, including axial bones (e.g., spine, pelvis, and proximal femur) . Most patients have multiple bone metastases by the time they are initially diagnosed. In such patients, radiation therapy is often the first choice of treatment. Surgical treatment is indicated for pathological fracture and impending fracture associated with cortical bone invasion in long bone metastasis. Spinal metastasis requires accurate imaging to evaluate the extent of bone metastasis ; surgical treatment is indicated when the spinal cord is compressed. Given reports that bisphosphonates decrease the incidence of pathological fractures, prescribing bisphosphonates at an early stage is likely to be an effective therapeutic strategy for bone metastasis.
肺癌骨转移需要对骨骼进行全面检查，包括中轴骨（如脊柱、骨盆和股骨近端）。大多数患者在初次诊断时就已经发生多处骨转移。对于这类患者，放射治疗通常是首选的治疗方法。手术治疗适用于长骨转移伴有皮质骨侵犯的病理性骨折和即将发生的骨折。脊柱转移需要精确的影像学检查以评估骨转移的范围；当脊髓受压时，需进行手术治疗。鉴于有报道称双膦酸盐可降低病理性骨折的发生率，早期开具双膦酸盐可能是骨转移的一种有效治疗策略。
