Yang Si-Zhen, Tang Yu, Zhang Ying, Chen Wu-Gui, Sun Jing, Chu Tong-Wei
Department of Orthopedics, Xinqiao Hospital, the Third Military Medical University, Chongqing, People's Republic of China.
Department of Orthopedics, Xinqiao Hospital, the Third Military Medical University, Chongqing, People's Republic of China.
World Neurosurg. 2017 Dec;108:163-175. doi: 10.1016/j.wneu.2017.08.130. Epub 2017 Sep 1.
Spinal metastases from lung cancer could result in life-threatening consequences. Few studies report the prognostic factors and compare different treatments in patients with spinal metastases from lung cancer.
From 2005 to 2014, we retrospectively reviewed and studied 140 patients with spinal metastases from lung cancer according to different treatments. To estimate overall survival and identify prognostic factors for survival, the Kaplan-Meier method and Cox regression analysis were adopted. In addition, the Kaplan-Meier method was used to compare different treatments for overall survival.
All patients in a conservative group and a percutaneous vertebroplasty group died at a median survival time of 7 months for both groups. As for patients in the open-surgery group, 42 patients died at a median of 11 months, and 7 patients who were still alive at the time of this study were followed for a median of 29 months. Multivariate analysis suggested that better survival was significantly associated with American Spinal Injury Association grade D/E on admission, American Spinal Injury Association grade E after surgery, Eastern Cooperative Oncology Group performance status 1-2, and adjuvant radiation therapy in all 3 groups. In addition, Kaplan-Meier analysis showed that the overall survival rate of the open-surgery group (14.3%) was better than that of conservative group (0%) and the percutaneous vertebroplasty group (0%).
A better overall survival outcome might be achieved by a series of comprehensive and individualized treatments and personalized treatment.
肺癌脊柱转移可导致危及生命的后果。很少有研究报道肺癌脊柱转移患者的预后因素并比较不同治疗方法。
2005年至2014年，我们根据不同治疗方法对140例肺癌脊柱转移患者进行了回顾性研究。采用Kaplan-Meier法和Cox回归分析来评估总生存期并确定生存的预后因素。此外，使用Kaplan-Meier法比较不同治疗方法的总生存期。
保守治疗组和经皮椎体成形术组的所有患者中位生存时间均为7个月。对于开放手术组的患者，42例患者中位生存11个月死亡，本研究时仍存活的7例患者中位随访29个月。多因素分析表明，较好的生存与入院时美国脊髓损伤协会（ASIA）分级D/E、术后ASIA分级E、东部肿瘤协作组（ECOG）体能状态1-2以及所有3组的辅助放疗显著相关。此外，Kaplan-Meier分析显示，开放手术组的总生存率（14.3%）优于保守治疗组（0%）和经皮椎体成形术组（0%）。
通过一系列综合、个体化的治疗和个性化治疗可能会取得更好的总生存结果。
