Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara 634-8521, Nara, Japan.
Department of Rehabilitation Medicine, Nara Medical University, 840, Shijo-cho, Kashihara 634-8521, Nara, Japan.
Curr Oncol. 2021 Aug 29;28(5):3347-3372. doi: 10.3390/curroncol28050290.
The number of patients with bone metastasis increases as medical management and surgery improve the overall survival of patients with cancer. Bone metastasis can cause skeletal complications, including bone pain, pathological fractures, spinal cord or nerve root compression, and hypercalcemia. Before initiation of treatment for bone metastasis, it is important to exclude primary bone malignancy, which would require a completely different therapeutic approach. It is essential to select surgical methods considering the patient's prognosis, quality of life, postoperative function, and risk of postoperative complications. Therefore, bone metastasis treatment requires a multidisciplinary team approach, including radiologists, oncologists, and orthopedic surgeons. Recently, many novel palliative treatment options have emerged for bone metastases, such as stereotactic body radiation therapy, radiopharmaceuticals, vertebroplasty, minimally invasive spine stabilization with percutaneous pedicle screws, acetabuloplasty, embolization, thermal ablation techniques, electrochemotherapy, and high-intensity focused ultrasound. These techniques are beneficial for patients who may not benefit from surgery or radiotherapy.
随着癌症患者整体生存率的提高,医学治疗和手术的进步使得骨转移患者的数量增加。骨转移可导致骨骼并发症,包括骨痛、病理性骨折、脊髓或神经根压迫以及高钙血症。在开始治疗骨转移之前,排除原发性骨恶性肿瘤非常重要,因为这需要完全不同的治疗方法。考虑到患者的预后、生活质量、术后功能和术后并发症的风险,选择手术方法至关重要。因此,骨转移的治疗需要多学科团队的方法,包括放射科医生、肿瘤学家和骨科医生。最近,出现了许多针对骨转移的新的姑息治疗选择,如立体定向体部放射治疗、放射性药物、椎体成形术、经皮椎弓根螺钉微创脊柱稳定术、髋臼成形术、栓塞、热消融技术、电化学疗法和高强度聚焦超声。这些技术对那些可能无法从手术或放疗中受益的患者有益。