脊柱转移瘤治疗的Meta分析研究进展

Advances in meta-analysis of treatment of spine metastasis

随着癌症患者生存率的提高,肿瘤的脊柱转移日益严重。若不治疗可引起疼痛、椎体稳定性减弱、神经功能障碍等,严重影响患者生存能力和生活质量。脊柱转移瘤的治疗是十分复杂的,随着研究的不断深入,外科技术的不断进步和放射外科的实现彻底改变了脊柱转移瘤的治疗模式。脊柱转移瘤的手术和非手术治疗有望在未来得到不断的改进。目前治疗方法包括传统肿瘤全切术、椎板切除减压术、椎体成形术、椎体后凸成形术、射频消融技术和微创手术等外科手段;常规放射治疗、立体定向放射治疗和调强放射治疗等疗法。笔者对已发表的文献中脊柱转移瘤患者的治疗方法的选择和疗效的Meta分析研究进行了总结分析。

As patients with cancer live longer, spine metastasis is a growing problem. Untreated, it can cause pain, instability and neurologic deficit, which can severely alter the patients＇ ability and quality of life. Management of spine metastasis is quite complex. Advances in research and the advances of surgical techniques and radiosurgical implementation have altered drastically the treatment paradigm for spine metastasis. The future remains bright for continued improvement in the surgical and nonsurgical management of the patients with spine metastasis. Current treatments include conventional tumor en bloc resection, laminectomy, vertebroplast, kyphoplasty, radiofrequency ablation, minimally invasive surgery ; conventional RT, stereotactic radiosurgery and intensity-modulated radiation. The authors analyzed meta-analysis of the treatment options and curative effect of patients with spinal metastases in the published literature.