For many spine surgeons, patients with metastatic cancer are often present in an emergent situation with rapidly progressive neurological dysfunction. Since the Patchell trial, scoring systems such as NOMS and SINS have emerged to guide the extent of surgical excision and fusion in the context of chemotherapy and radiation therapy. Yet, while multidisciplinary decision-making is the gold standard of cancer care, in the middle of the night, when a patient needs spinal surgery, the wealth of chemotherapy data, clinical trials, and other medical advances can feel overwhelming. The goal of this review is to provide an overview of the relevant molecular biomarkers and therapies driving patient survival in lung, breast, prostate, and renal cell cancer. We highlight the molecular differences between primary tumors (i.e., the patient’s original lung cancer) and the subsequent spinal metastasis. This distinction is crucial, as there are limited data investigating how metastases respond to their primary tumor’s targeted molecular therapies. Integrating information from primary and metastatic markers allows for a more comprehensive and personalized approach to cancer treatment.
对于许多脊柱外科医生而言，转移性癌症患者常以神经功能快速恶化的急诊形式就诊。自帕切尔试验以来，诸如NOMS和SINS等评分系统相继出现，用于指导化疗和放疗背景下的手术切除与融合范围。然而，尽管多学科决策是癌症治疗的金标准，但在深夜患者急需脊柱手术时，海量的化疗数据、临床试验及其他医学进展可能令人无所适从。本综述旨在概述影响肺癌、乳腺癌、前列腺癌和肾细胞癌患者生存的关键分子生物标志物及治疗方法，重点探讨原发性肿瘤（如患者原发肺癌）与后续脊柱转移瘤之间的分子差异。这一区分至关重要，因为关于转移灶对原发肿瘤靶向分子治疗反应的研究数据十分有限。整合原发灶与转移灶的分子标记信息，可为癌症治疗提供更全面、个性化的诊疗策略。
Therapeutic Opportunities for Biomarkers in Metastatic Spine Tumors
肿瘤(癌症)患者之家