Background: This study investigated the efficacy of stereotactic radiosurgery (SRS) in managing spinal metastasis. Traditionally, surgery was the primary approach, but SRS has emerged as a promising alternative. Objective: The study aims to evaluate the efficacy of stereotactic radiosurgery in the management of spinal metastasis in terms of local tumor control, patient survival, and quality of life, identifying both advantages and limitations of SRS. Methods: Through an extensive literature search in PubMed with cross-referencing, relevant full-text-available papers published between 2012 and 2022 in English or German were included. The search string used was “metastatic spine diseases AND SRS OR stereotactic radiosurgery”. Results: There is growing evidence of SRS as a precise and effective treatment. SRS delivers high radiation doses while minimizing exposure to critical neural structures, offering benefits like pain relief, limited tumor growth, and a low complication rate, even for tumors resistant to traditional radiation therapies. SRS can be a primary treatment for certain metastatic cases, particularly those without spinal cord compression. Conclusions: SRS appears to be a preferable option for oligometastasis and radioresistant lesions, assuming there are no contraindications. Further research is necessary to refine treatment protocols, determine optimal radiation dose and fractionation schemes, and assess the long-term effects of SRS on neural structures.
背景：本研究探讨了立体定向放射外科（SRS）在脊柱转移瘤治疗中的疗效。传统上，手术是主要治疗手段，但SRS已成为一种有前景的替代方案。目的：本研究旨在从局部肿瘤控制、患者生存率和生活质量等方面评估立体定向放射外科治疗脊柱转移瘤的疗效，并明确SRS的优势与局限性。方法：通过PubMed数据库进行广泛文献检索并交叉引用，纳入2012年至2022年间以英文或德文发表且可获取全文的相关论文。检索关键词为“转移性脊柱疾病 AND SRS OR 立体定向放射外科”。结果：越来越多的证据表明SRS是一种精准有效的治疗方法。SRS能够提供高剂量放射治疗，同时最大限度减少对关键神经结构的照射，具有缓解疼痛、抑制肿瘤生长及并发症发生率低等优势，即使对传统放疗耐受的肿瘤也有效。对于某些转移病例，特别是无脊髓压迫的患者，SRS可作为主要治疗手段。结论：对于寡转移和放射耐受性病灶，若无禁忌症，SRS似乎是更优选择。未来需进一步研究以完善治疗方案、确定最佳放射剂量与分割模式，并评估SRS对神经结构的长期影响。
Stereotactic Radiosurgery in Metastatic Spine Disease—A Systemic Review of the Literature
肿瘤(癌症)患者之家