脊柱转移瘤的新型决策框架及治疗进展

A new decision-making framework and progress in treatment of spinal metastatic tumors

脊柱是晚期恶性肿瘤最常见的骨转移部位,可造成椎体病理性骨折以及脊髓、神经压迫并导致疼痛、畸形甚至瘫痪,严重影响肿瘤患者的生存质量。既往主要依据Tomita、Tokuhashi等评分对脊柱转移瘤进行预后评估,并确定治疗方案。随着对肿瘤生物学的研究逐渐深入,新的治疗方法不断涌现,并取得了良好的治疗效果,随之出现了新的脊柱转移瘤的预后评估模型及治疗决策框架。同时,脊柱转移瘤的微创外科治疗、立体定向放疗以及靶向治疗也取得了较大进展。本文对脊柱转移瘤的新型决策框架及治疗进展作一综述。

Spinal column is the most common bone metastasis site of advanced malignant tumor,which can cause pathological fracture of vertebral body,spinal cord and nerve compression and pain,deformity and even paralysis,seriously affecting the quality of life of tumor patients.In the past,Tomita,Tokuhashi and other scores were mainly used to evaluate the prognosis of spinal metastasis and determine the treatment plan.With the deepening of the research on tumor biology,new therapeutic methods keep emerging and have achieved good therapeutic effects,and a new prognostic evaluation model and treatment decisionmaking framework for spinal metastatic tumors have emerged.At the same time,the minimally invasive surgical treatment,stereotactic radiotherapy and targeted therapy of spinal metastases have also made great progress.