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肺癌继发转移性脊髓压迫患者的预后因素:文献系统综述

Prognostic factors in patients with metastatic spinal cord compression secondary to lung cancer: a systematic review of the literature.

作者信息

da Silva Gustavo Telles, Bergmann Anke, Santos Thuler Luiz Claudio

机构信息

National Cancer Institute, Federal University of the State of Rio de Janeiro, Rio De Janeiro, Brazil.

National Cancer Institute, Augusto Motta University Center, Rio De Janeiro, Brazil.

出版信息

Eur Spine J. 2015 Oct;24(10):2107-13. doi: 10.1007/s00586-015-4157-x. Epub 2015 Jul 29.

Abstract

PURPOSE

The Metastatic spinal cord compression (MSCC) secondary to lung cancer (LC) has worse prognosis when compared to MSCC related to other solid tumors. The purpose of this study is to identify the survival time and the prognostic factors in the MSCC secondary to LC.

METHODS

A systematic review of the literature has been carried out. Studies published between January 2005 and March 2015 were identified through the electronic database PubMed and LILACS. Two independent reviewers selected the articles.

RESULTS

7 studies were identified, which met the inclusion criteria, involving 1010 patients. The survival in 6 and 12 months ranged between 18 and 61%, and between 3.8 and 32%, respectively. The median survival ranged between 2.8 and 9 months. The variables related to the survival improvement were: female, performance status 1 or 2, pre-radiotherapy and postoperative ambulatory status, absence of bone metastases and visceral metastases, interval from cancer diagnosis to spinal metastases or radiotherapy of MSCC>15 months, slower (>7 days) development of motor deficit, and the neurological status at the postoperative.

CONCLUSIONS

The prognosis of the MSCC secondary to LC was poor. Considering the small number of studies identified, further research is needed to identify prognostic factors that are independent of the MSCC secondary to LC.

摘要

目的

与其他实体瘤相关的转移性脊髓压迫症(MSCC)相比,肺癌(LC)继发的MSCC预后更差。本研究的目的是确定LC继发MSCC的生存时间及预后因素。

方法

进行了一项系统的文献综述。通过电子数据库PubMed和LILACS检索2005年1月至2015年3月发表的研究。由两名独立评审员筛选文章。

结果

确定了7项符合纳入标准的研究,涉及1010例患者。6个月和12个月的生存率分别在18%至61%和3.8%至32%之间。中位生存期在2.8至9个月之间。与生存改善相关的变量包括:女性、体力状况为1或2、放疗前及术后可走动状态、无骨转移和内脏转移、从癌症诊断到脊髓转移或MSCC放疗的间隔时间>15个月、运动功能障碍发展较慢(>7天)以及术后神经状态。

结论

LC继发MSCC的预后较差。鉴于所确定的研究数量较少,需要进一步研究以确定独立于LC继发MSCC的预后因素。

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