Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
Veterans Affairs Medical Center, Ann Arbor, MI, USA.
Curr Osteoporos Rep. 2018 Aug;16(4):512-518. doi: 10.1007/s11914-018-0463-7.
The purpose of this review was to examine the recent changes in the surgical treatment of bone metastases and how the treatment paradigm has shifted with the improvement of adjuvant therapies. How surgery fits into the local and systemic treatment was reviewed for bone metastases in different areas.
The more common use of targeted chemotherapies and focused high-dose radiation have altered the treatment paradigm of bone metastases. Overall changes in the surgical treatment of bone metastases have been driven by an increased multidisciplinary approach to metastatic cancer and the awareness that one type of surgery does not work for all patients. The individual patient treatment goals dictate the surgical procedures used to achieve these goals. Advancements in adjuvant therapy-like radiation and more targeted chemotherapies have allowed for less invasive surgical approaches and therefore faster recoveries and reduced surgical morbidity for patients.
本综述旨在探讨骨转移的手术治疗近期变化,以及辅助治疗的改善如何改变治疗模式。针对不同部位的骨转移,探讨了手术在局部和全身治疗中的作用。
靶向化疗和聚焦高剂量放疗的更广泛应用改变了骨转移的治疗模式。骨转移手术治疗的总体变化是由转移性癌症的多学科治疗方法的增加以及认识到并非所有患者都适用一种手术方式驱动的。个体患者的治疗目标决定了用于实现这些目标的手术程序。辅助治疗(如放疗和更靶向的化疗)的进步允许采用更微创的手术方法,从而为患者带来更快的康复和降低手术发病率。