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对于转移性瘤的NOMS方法:整合新技术以改善结果

W C Newman¹, A G Larsen², M H Bilsky²

¹Memorial Sloan Kettering Cancer Center, Chennai, Tamil Nadu, India.

Revista espanola de cirugia ortopedica y traumatologia

|August 10, 2023

概括

脊柱转移的治疗已经通过脊柱立体性放射性手术 (sSRS) 和微创手术取得了进展. 一个多学科的NOMS框架有助于决策,改善患者的治疗结果.

科学领域:

在瘤学瘤学.
神经外科神经外科
辐射瘤学辐射瘤学

背景情况:

脊柱转移的治疗方法在过去的20年里有了显著的进化.
脊柱立体放射性外科手术 (sSRS) 是一种变革性的整合,提供瘤杀伤剂量与脊髓节省.
证据支持sSRS安全性和有效性,用于持久的局部瘤控制,并发症率低.

研究的目的:

审查关于脊髓转移治疗的最新,基于证据的数据.
将当前的数据整合到一个决策框架 (NOMS) 中,用于管理转移性脊髓瘤.
突出新预测工具的需要,并审查长期结果.

主要方法:

对当前关于脊髓转移治疗的基于证据的数据的审查.
将数据集成到NOMS决策框架中.
强调多学科的方法,涉及各种医疗专家.

主要成果:

sSRS可提供持久的局部瘤控制,并发症率低,即使对于抗辐射瘤.
手术干预趋向于更少的侵略性,具有更好的结果的最小侵入性技术.
向性药物 (生物药物,检查点抑制剂) 改善了局部控制和患者的生存率.

结论:

在sSRS,微创手术和向治疗的进步需要更新的治疗策略.
该NOMS框架 (神经状态,Oologic瘤行为,机械稳定性,系统性疾病负担/医疗并发症) 提供了一个结构化的决策方法.
多学科的方法对于优化脊髓转移的复杂管理至关重要.

关键词:

脊椎转移的发生.脊髓是脊髓的一部分.姓名姓名姓名脊髓是指脊髓中的一些部分.脊柱转移发生在脊柱上

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