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脊柱转移性肿瘤外科治疗相关问题探讨
Hits: 700   Download times: 285   Received:July 10, 2023    
作者Author单位UnitE-Mail
徐美涛 XU Mei-tao 陆军军医大学第一附属医院骨科, 重庆 400030 Department of Orthopaedics, Southwest Hospital, the Third Military Medical University, Chongqing 400030, China  
蔡莎 CAI Sha 陆军军医大学第一附属医院麻醉科, 重庆 400030 Department of Anoothesiology, the First Hospital of Army Medical Univesty, Chongqing 400030, China  
侯天勇 HOU Tian-yong 陆军军医大学第一附属医院骨科, 重庆 400030 Department of Orthopaedics, Southwest Hospital, the Third Military Medical University, Chongqing 400030, China tianyonghou@126.com 
期刊信息:《中国骨伤》2023年36卷,第12期,第1203-1206页
DOI:10.12200/j.issn.1003-0034.2023.12.018
以外科为主导的多学科综合治疗模式已成为脊柱转移性肿瘤治疗的综合策略和整体观念,但脊柱转移性肿瘤的手术治疗不同于脊柱原发恶性肿瘤,手术只是多学科综合治疗模式当中的一个环节。因此,脊柱转移性肿瘤的外科治疗策略应首先立足于患者的生存评估,综合评估转移瘤的脊柱稳定性破坏、脊髓神经功能障碍、肿瘤生物学特点,制定适度的外科手术干预级别。应重视脊柱转移性肿瘤的微创治疗,结合放疗新技术、新辅助化疗、靶向治疗等内科治疗的进展,制定个体化、阶梯化的综合治疗模式,以缓解患者疼痛、重建脊柱稳定、避免瘫痪。在改善患者生存、增加局部肿瘤控制率和可能提高生存时间的同时,尽可能避免过度手术。
[关键词]:脊柱转移瘤  全椎节切除术  分离手术  立体定向放疗  多学科综合评估
 
Commentary on relevant issues in surgical treatment of spinal metastatic tumors
Abstract:The multidisciplinary treatment model led by surgery has become a comprehensive strategy and overall concept for the treatment of spinal metastatic tumors. But the surgical treatment of spinal metastatic tumors is different from primary malignant tumors of the spine. Surgery is only a part of the multidisciplinary comprehensive treatment. Therefore,the following aspects need to be evaluated comprehensively based on the survival assessment,evaluation of spinal stability damage,nerve dysfunction,and oncological characteristics of the metastatic tumors with a reasonable surgical intervention. The attention should be paid to the minimally invasive treatment of spinal metastases,progress of new radiotherapy technology,neoadjuvant chemotherapy,targeted drug therapy and other medical treatment to make a comprehensive and individualization decision which is benefit to relieve patients' pain,reconstruct spinal stability and avoid paralysis. While improving patient survival,increasing local tumor control rate and possibly prolonging survival time,avoiding excessive surgery as much as possible.
KEYWORDS:Spinal mtastasis  Total en bloc spondylectomy  Separation surgery  Stereotactic body radiation therapy  Multidisciplinary comprehensive assessment
 
引用本文,请按以下格式著录参考文献:
中文格式:徐美涛,蔡莎,侯天勇.脊柱转移性肿瘤外科治疗相关问题探讨[J].中国骨伤,2023,36(12):1203~1206
英文格式:XU Mei-tao,CAI Sha,HOU Tian-yong.Commentary on relevant issues in surgical treatment of spinal metastatic tumors[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(12):1203~1206
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