Sekar Vashisht, Walsh Jamie, Pearson Luke H, Barzilai Ori, Sharif Salman, Zileli Mehmet
Department of Neurological Surgery, University of Florida Jacksonville, Jacksonville, FL, USA.
Department of Neurological Surgery, Queens University Belfast, Belfast, Northern Ireland.
Neurosurg Rev. 2024 Dec 30;48(1):12. doi: 10.1007/s10143-024-03123-3.
This review aims to formulate the most current, evidence-based recommendations regarding radiation therapy, radiosurgery, and chemotherapy for patients with metastatic spine tumors.
A systematic literature using PRISMA methodology was performed from 2010-2023 using the search terms "radiosurgery," "radiation therapy," "external beam radiation therapy," or "stereotactic body radiation therapy" in conjunction with "spinal," "spine," "metastasis," "metastases," or "metastatic."
Spinal metastases should be managed in a multidisciplinary team consisting of spine surgeons, radiation oncologists, radiologists and oncologists. Patients identified as potential candidates for SRS/EBRT using internationally recognized frameworks and criteria should be assessed by surgeons to see if surgical cyto-reduction/ separation surgery can be achieved. Choices for treatment of recurrence include re-irradiation with SBRT vs EBRT, surgical debulking, additional chemotherapy or palliative care. There is a lack of current clinical evidence to support the routine use of targeted therapies in the management of metastatic spinal tumors.
Improving the management of spinal metastasis will lead to increased quality of life and improved survival. This review provides current, evidence-based guidelines on radiation therapy, radiosurgery, and chemotherapy for patients with metastatic spine tumors.
本综述旨在针对转移性脊柱肿瘤患者制定有关放射治疗、放射外科手术和化疗的最新循证建议。
采用PRISMA方法，于2010年至2023年进行了一项系统文献检索，检索词为“放射外科手术”“放射治疗”“外照射放射治疗”或“立体定向体部放射治疗”，并结合“脊柱”“脊椎”“转移”“转移灶”或“转移性的”。
脊柱转移瘤应由脊柱外科医生、放射肿瘤学家、放射科医生和肿瘤学家组成的多学科团队进行管理。使用国际认可的框架和标准确定为SRS/EBRT潜在候选者的患者，应由外科医生评估是否可以实现手术减瘤/分离手术。复发治疗的选择包括使用SBRT与EBRT进行再照射、手术减瘤、追加化疗或姑息治疗。目前缺乏临床证据支持在转移性脊柱肿瘤管理中常规使用靶向治疗。
改善脊柱转移瘤的管理将提高生活质量并延长生存期。本综述为转移性脊柱肿瘤患者的放射治疗、放射外科手术和化疗提供了最新的循证指南。
