Jabbari Siavash, Gerszten Peter C, Ruschin Mark, Larson David A, Lo Simon S, Sahgal Arjun
From the *Department of Radiation Oncology, The Laurel Amtower Cancer Institute and Neuro-oncology Center, Sharp Healthcare, San Diego, CA; †Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA; ‡Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada; §Department of Radiation Oncology, University of California San Francisco, San Francisco, CA; and ∥Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH.
Cancer J. 2016 Jul-Aug;22(4):280-9. doi: 10.1097/PPO.0000000000000205.
Spine metastases can be a debilitating and difficult therapeutic challenge for a significant number of cancer patients. Surgical management of spine metastases is often limited because of the complexity, risks, and recovery delays associated with open invasive surgical procedures. Conventional palliative external beam radiation therapy is the most common treatment modality. However, it is associated with limited palliative efficacy and local tumor control, including in the postoperative setting. In the era of improving systemic disease control, spine stereotactic body radiotherapy is fast emerging as the therapeutic modality of choice for selected de novo, postoperative, and salvage reirradiation spine metastases patients. Considerable expertise, multidisciplinary collaboration, and rigid adherence to quality metrics are required for the safe application of this highly conformal ablative therapy. This review highlights the current state of the evidence, understanding of the late effects, and technological requirements for spine stereotactic body radiotherapy specific to spinal metastases.
脊柱转移瘤对许多癌症患者来说可能是一个使人衰弱且具有挑战性的治疗难题。由于开放性侵入性手术操作的复杂性、风险和恢复延迟，脊柱转移瘤的手术治疗往往受到限制。传统的姑息性外照射放疗是最常见的治疗方式。然而，它的姑息疗效和局部肿瘤控制有限，包括在术后情况中。在全身疾病控制不断改善的时代，脊柱立体定向体部放疗正迅速成为选定的初发、术后和挽救性再照射脊柱转移瘤患者的首选治疗方式。安全应用这种高度适形的消融治疗需要相当的专业知识、多学科协作以及严格遵守质量指标。本综述重点介绍了脊柱立体定向体部放疗针对脊柱转移瘤的现有证据状况、对晚期效应的认识以及技术要求。
