To compare total en bloc spondylectomy (TES) with stereotactic ablative radiotherapy (SABR) for single spinal metastasis, we undertook a single center retrospective study. We identified patients who had undergone TES or SABR for a single spinal metastasis between 2000 and 2019. Medical records and images were reviewed for patient and tumor characteristics, and oncologic outcomes. Patients who received TES were matched to those who received SABR to compare local control and survival. A total of 89 patients were identified, of whom 20 and 69 received TES and SABR, respectively. A total of 38 matched patients were analyzed (19 TES and 19 SABR). The median follow-up period was 54.4 (TES) and 26.1 months (SABR) for matched patients. Two-year progression-free survival (PFS) and overall survival (OS) rates were 66.7% and 72.2% in the TES and 38.9% and 50.7% in the SABR group, respectively. At the final follow-up of the matched cohorts, no significant differences were noted in OS (p= 0.554), PFS (p= 0.345) or local progression (p= 0.133). The rate of major complications was higher in the TES than in the SABR group (21.1% vs. 10.5%,p= 0.660). These findings suggest that SABR leads to fewer complications compared to TES, while TES exhibits better mid-term control of metastatic tumors.
为比较全脊椎整块切除术与立体定向消融放疗治疗单发脊柱转移瘤的疗效，我们开展了一项单中心回顾性研究。研究对象为2000年至2019年间接受上述两种术式治疗的单发脊柱转移瘤患者。通过查阅病历资料及影像学检查，收集患者基本特征、肿瘤学参数及治疗结局数据。采用配对研究方法将接受全脊椎整块切除术的患者与接受立体定向消融放疗的患者进行匹配，比较两组局部控制率及生存期。共纳入89例患者，其中全脊椎整块切除术组20例，立体定向消融放疗组69例。经配对后获得38例匹配病例（两组各19例）。匹配患者中位随访时间分别为54.4个月（全脊椎整块切除术组）和26.1个月（立体定向消融放疗组）。全脊椎整块切除术组2年无进展生存率和总生存率分别为66.7%和72.2%，立体定向消融放疗组分别为38.9%和50.7%。在匹配队列的最终随访中，两组总生存期（p=0.554）、无进展生存期（p=0.345）及局部进展率（p=0.133）均无统计学差异。全脊椎整块切除术组主要并发症发生率高于立体定向消融放疗组（21.1%对10.5%，p=0.660）。研究结果表明，与全脊椎整块切除术相比，立体定向消融放疗并发症更少，而全脊椎整块切除术在转移瘤中期控制方面更具优势。
肿瘤(癌症)患者之家