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骨骼转移瘤的现代治疗:近期文献中的多学科性与寡转移概念

Modern Treatment of Skeletal Metastases: Multidisciplinarity and the Concept of Oligometastasis in the Recent Literature.

作者信息

Trovarelli Giulia, Rizzo Arianna, Zinnarello Felicia Deborah, Cerchiaro Mariachiara, Angelini Andrea, Pala Elisa, Ruggieri Pietro

机构信息

Department of Orthopedics and Orthopedic Oncology, University of Padua, 35122 Padua, Italy.

Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35122 Padua, Italy.

出版信息

Curr Oncol. 2025 Apr 11;32(4):226. doi: 10.3390/curroncol32040226.

Abstract

Bone metastases are a major concern in cancer management since they significantly contribute to morbidity and mortality. Metastatic lesions, commonly arising from breast, prostate, lung, and kidney cancers, affect approximately 25% of cancer patients, leading to severe complications such as pain, fractures, and neurological deficits. This narrative review explores contemporary approaches to bone metastases, emphasizing a multidisciplinary strategy and the evolving concept of oligometastatic disease. Oligometastases, defined by limited metastatic spread (1-5 lesions), offer a potential window for curative treatment through aggressive interventions, including stereotactic ablative radiotherapy and resection surgery. Tumor boards, integrating systemic therapies with local interventions, are crucial to optimize treatment. Despite promising results, gaps remain in defining optimal treatment sequences and refining patient selection criteria. Future research should focus on personalized approaches, leveraging biomarkers and advanced imaging to enhance outcomes and the quality of life in patients with bone metastases.

摘要

骨转移是癌症治疗中的一个主要问题,因为它们对发病率和死亡率有显著影响。转移瘤通常起源于乳腺癌、前列腺癌、肺癌和肾癌,约25%的癌症患者会受到影响,导致疼痛、骨折和神经功能缺损等严重并发症。这篇叙述性综述探讨了骨转移的当代治疗方法,强调多学科策略以及寡转移疾病这一不断演变的概念。寡转移定义为转移扩散有限(1 - 5个病灶),通过包括立体定向消融放疗和切除手术在内的积极干预措施,为治愈性治疗提供了潜在机会。肿瘤学专家小组将全身治疗与局部干预相结合,对优化治疗至关重要。尽管取得了有前景的结果,但在确定最佳治疗顺序和完善患者选择标准方面仍存在差距。未来的研究应专注于个性化方法,利用生物标志物和先进成像技术来改善骨转移患者的治疗效果和生活质量。

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