Kim Min J, Marianayagam Neelan J, Chandra Ankush, Ranalli Carlotta, Schonfeld Ethan, Avila-Madrigal Juan P, Flusche Ann Marie E, Schoeffler Katherine, Alomari Safwan, Rao Namratha B, Yoo Kelly, Lam Fred C, Park David J, Fanous Andrew A, Chang Steven D, Lim Michael, Veeravagu Anand
Harvey W. Cushing Neuro-Oncology Laboratories (HCNL), Department of Neurosurgery, Mass General Brigham and Harvard Medical School, Boston, MA, 02115, USA.
Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, 94305, USA.
Med Oncol. 2025 May 14;42(6):210. doi: 10.1007/s12032-025-02764-8.
With improved cancer survivorship, the incidence of metastatic bone disease has risen, and metastatic spinal tumors (MSTs) have emerged as a common yet significant clinical challenge. These tumors may compromise the integrity of vertebral bodies leading to pathological fractures and neurological compromise from nerve root or spinal cord compression dramatically affecting the patient's quality of life. Despite the associated morbidity and mortality, optimal treatment strategies remain elusive. Here, in our review, we provide a comprehensive analysis of the contemporary MST treatment strategies, encompassing surgical interventions, advanced radiotherapy modalities, and evolving systemic therapies including chemotherapeutic and immunotherapeutic approaches. We critically evaluate each modality's development trajectory, clinical efficacy, therapeutic advantages, and inherent limitations. Our analysis reveals a definitive shift toward precision-guided radiotherapy and minimally invasive surgical techniques that balance therapeutic efficacy with reduced morbidity. These findings underscore the necessity for multidisciplinary management and highlight promising avenues for therapeutic innovation. As treatment paradigms evolve, integration of these advanced modalities offers new hope for this vulnerable patient population facing a challenging oncological complication.
随着癌症生存率的提高，转移性骨病的发病率有所上升，转移性脊柱肿瘤（MST）已成为一个常见且严峻的临床挑战。这些肿瘤可能会损害椎体的完整性，导致病理性骨折以及神经根或脊髓受压引起的神经功能损害，极大地影响患者的生活质量。尽管存在相关的发病率和死亡率，但最佳治疗策略仍不明确。在此，在我们的综述中，我们对当代MST治疗策略进行了全面分析，包括手术干预、先进的放疗方式以及不断发展的全身治疗，包括化疗和免疫治疗方法。我们批判性地评估了每种治疗方式的发展轨迹、临床疗效、治疗优势和固有局限性。我们的分析显示出明显向精确制导放疗和微创手术技术的转变，这些技术在平衡治疗效果与降低发病率方面取得了进展。这些发现强调了多学科管理的必要性，并突出了治疗创新的有前景的途径。随着治疗模式的不断发展，这些先进治疗方式的整合为面临具有挑战性的肿瘤并发症的这一脆弱患者群体带来了新的希望。
