[Combination therapy of 91 cases of spinal metastases]

The majority of spinal neoplasms are metastatic lesions. This paper reports results of combination therapy of ninety-one cases of spinal metastasis verified by pathology. Most of them were metastases from breast, lung, thyroid and gastrointestinal cancers. Multiple metastatic lesions were mainly treated by chemotherapy. Radiotherapy was for radio-sensitive solitary lesions. Indication for operation included: (1) isolated spinal focus with unknown site of primary tumor; (2) recurrence or aggravation of tumor after chemotherapy or radiotherapy; (3) isolated radioresistant focus; and (4) the patients having paraplegia or an instable spine. Thirty cases were mainly treated by chemotherapy, 10 by radiotherapy, and 51 by operation. After the combination therapy, 13 cases were completely free of symptoms, 44 alleviated and 11 invalid. Of the 39 cases having paraplegia, 3 had complete recovery, 15 partial recovery and 21 no improvement. Of 85 cases having been followed up for 1-4 years, 51 cases (59.3%) survived for 3-11 months, 25 (29.1%) for 1-2 years and 10 (11.6%) for 2-3 years. The average survival time was 10.5 months. Analyzing the clinical and radiographic manifestations of the tumors and their treatment and prognosis, we consider that early diagnosis and combination therapy are the major factors influencing the therapeutic effect of spinal metastatic tumors.