Yáñez M Loreto, Miller Julie J, Batchelor Tracy T
Department of Radiation Oncology, Arturo López Pérez Foundation, Santiago, Chile.
Department of Neurology, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts.
Cancer. 2017 Apr 1;123(7):1106-1114. doi: 10.1002/cncr.30521. Epub 2016 Dec 27.
Epidural metastases occur in 5% to 10% of cancer patients and represent a neurological emergency. Patients most commonly present with an acute onset of motor weakness, and restoration of neurological function is critically dependent on prompt diagnosis and treatment. This review discusses the clinical, epidemiological, and radiological features associated with epidural metastases and resulting spinal cord compression. Moreover, current treatment paradigms are reviewed. The timely initiation of radiation as well as surgery in select cases is critical for preserving neurological function and achieving local tumor control and pain control. Future studies investigating surgical and radiation treatment for metastatic epidural cord compression are urgently needed. Cancer 2017;123:1106-1114. © 2016 American Cancer Society.
硬膜外转移瘤在5%至10%的癌症患者中出现，是一种神经急症。患者最常见的表现是急性运动无力，神经功能的恢复严重依赖于及时的诊断和治疗。本综述讨论了与硬膜外转移瘤及由此导致的脊髓压迫相关的临床、流行病学和放射学特征。此外，还对当前的治疗模式进行了综述。在特定病例中及时开始放疗以及手术对于保留神经功能、实现局部肿瘤控制和疼痛控制至关重要。迫切需要开展关于转移性硬膜外脊髓压迫的手术和放疗治疗的未来研究。《癌症》2017年；123:1106 - 1114。©2016美国癌症协会。
