Targeted therapy has greatly improved the outlook for patients with spinal metastatic cancers. Scoring systems like the Tokuhashi or Tomita scores are commonly used to predict prognosis and inform surgical decisions, but they are outdated and fail to consider recent advancements. We aimed to investigate the current state of the literature and treatment options pertaining to advancements in targeted therapy compared to other forms of medical management for metastatic spinal tumors. This study represents the first comprehensive systematic review that encompasses the most common primary cancers that metastasize to the spine and evaluates the median overall survival (mOS) across five different medical treatment modalities as well as surgical intervention. Additionally, our study analyzes the tumor receptor status in conjunction with these treatments. A PubMed search was conducted, and according to the PRISMA guidelines, 28 articles out of 1834 met the inclusion criteria. The pooled data analysis highlighted the superior efficacy of targeted therapy, evidenced by a significant improvement in the mOS and lower hazard ratios in patients with lung and breast cancers who received targeted therapy compared to those who did not. Our study provides valuable insights into the recent advancements in the medical management of metastatic spinal tumors. Future indications include incorporating this literature into personalized treatment approaches for metastatic spinal tumors.
靶向治疗显著改善了脊柱转移癌患者的预后。目前临床上常用Tokuhashi评分或Tomita评分等系统来预测预后并指导手术决策，但这些评分系统已显陈旧，未能纳入最新治疗进展。本研究旨在系统评估靶向治疗相较于其他医疗手段在脊柱转移瘤治疗中的最新进展。本综述首次系统涵盖了最常见的脊柱转移原发癌类型，并评估了五种不同医疗方案及手术干预的中位总生存期（mOS）。此外，本研究还结合肿瘤受体状态对治疗方案进行了综合分析。通过PubMed数据库检索，依据PRISMA指南从1834篇文献中筛选出28篇符合纳入标准的研究。汇总数据分析表明，靶向治疗在肺转移癌和乳腺转移癌患者中展现出显著优势：接受靶向治疗的患者不仅中位总生存期显著延长，风险比也明显降低。本研究为脊柱转移瘤的现代医疗管理进展提供了重要参考。未来研究方向包括将这些循证依据整合到脊柱转移瘤的个体化治疗方案中。
肿瘤(癌症)患者之家