Background: The advent of novel cancer therapies has significantly improved both life expectancy and quality of life for cancer patients. However, this has also led to an increased incidence of metastases, particularly spinal metastases, which pose a significant clinical challenge due to their potential to compromise spinal stability, mobility and neurological function. Objective: The aim of this study is to identify current symptom scores, determine the diagnosis, evaluate treatment modalities, and review prognostic scores and management algorithms for spinal metastases to aid in therapeutic decision making. Methods: A systematic literature review was conducted in PubMed focusing on available full-text review articles published in English between 1 January 2012 and 1 July 2022. The search terms were “spinal metastasis OR spinal metastases OR spine metastasis OR spine metastases AND treatment OR management”. Results: Several treatment algorithms, including NOMS (neurology, oncology, mechanical stability, and systemic disease) and LMNOP (localization, mechanical instability, neurology, oncology), have been proposed to guide clinical decision making. However, the development of prognostic scores that incorporate the impact of newer treatment modalities remains an important area of research. Conclusions: Effective management of spinal metastases requires a multidisciplinary approach, with emphasis on early diagnosis. Treatment decisions are individualized. Further research is essential to refine treatment strategies and improve patient outcomes.
背景：新型癌症疗法的出现显著改善了癌症患者的预期寿命和生活质量。然而，这也导致转移瘤（尤其是脊柱转移瘤）的发病率增加。脊柱转移瘤因其可能损害脊柱稳定性、活动能力和神经功能而构成重大临床挑战。目的：本研究旨在梳理现有症状评分体系，明确诊断方法，评估治疗模式，并综述脊柱转移瘤的预后评分和管理路径，以辅助临床治疗决策。方法：在PubMed数据库中对2012年1月1日至2022年7月1日期间发表的英文全文综述文献进行系统性检索，检索关键词为"脊柱转移瘤 AND 治疗 OR 管理"。结果：目前已有包括NOMS（神经功能、肿瘤学、机械稳定性、全身性疾病）和LMNOP（病灶定位、机械不稳定性、神经功能、肿瘤学）在内的多种治疗路径被提出以指导临床决策。然而，开发能够整合新型治疗模式影响的预后评分体系仍是重要研究方向。结论：脊柱转移瘤的有效管理需要多学科协作，并强调早期诊断。治疗决策应个体化。进一步完善治疗策略、改善患者预后仍需深入研究。
Current Concepts in the Management and Treatment of Spinal Metastases—A Systematic Literature Review
肿瘤(癌症)患者之家