Background: Spinal metastasis is a rare complication of supratentorial glioblastoma. We report the clinical features and prognosis of this phenomenon and review the relevant literature.Methods: This is a territory-wide, multicentre, retrospective review using data from the Hong Kong High-grade Glioma Registry from 2006 to 2023. Data of consecutive adult patients diagnosed with supratentorial glioblastoma and spinal metastasis were extracted and analyzed.Results: Among the 1342 patients with supratentorial glioblastoma, 15 were diagnosed to have spinal metastasis (1.1%). The median time to spinal metastasis from the initial diagnosis of glioblastoma was 38.7 weeks (IQR: 15.1–57.6). Multi-level spinal involvement was present in 60% (9/15) of patients. Neither the topographical location of the tumor in relation to the subventricular zone, extent of resection, occurrence of intraoperative ventricular entry, normethylguanine methyltransferase(MGMT) promoter methylation status predicted the time to spinal metastasis. The median overall survival was 44.1 weeks (IQR: 29.9–80.2), and the median post-spinal metastasis survival was 12.6 weeks (IQR: 5.0–15.0). Two-thirds of patients received spinal radiotherapy, 26.7% had systemic therapy (chemotherapy, targeted therapy, and/or immunotherapy), and 13.3% underwent surgical spinal decompression. No significant survival improvement was observed among patients who received spinal radiotherapy (HR: 0.61; 95% CI: 0.17–2.23) or systemic therapy (HR: 0.94; 95% CI: 0.20–4.39).Conclusions: This case series illustrates the management practices and clinical course of glioblastoma patients with spinal metastasis. No treatment modality was proven to be superior. Treatment remains largely palliative and should be tailored on an individual basis.
背景：脊髓转移是幕上胶质母细胞瘤的一种罕见并发症。本文旨在报告该现象的临床特征及预后，并对相关文献进行综述。 方法：本研究为一项基于香港高级别胶质瘤登记库（2006-2023年）的全区域多中心回顾性分析。我们提取并分析了连续确诊的幕上胶质母细胞瘤伴脊髓转移成年患者的临床资料。 结果：在1342例幕上胶质母细胞瘤患者中，15例确诊脊髓转移（1.1%）。从胶质母细胞瘤初诊至发生脊髓转移的中位时间为38.7周（四分位距：15.1-57.6）。60%（9/15）患者存在多节段脊柱受累。肿瘤与脑室下区的解剖位置关系、切除范围、术中脑室开放情况、O⁶-甲基鸟嘌呤-DNA甲基转移酶（MGMT）启动子甲基化状态均未对脊髓转移时间产生预测作用。患者中位总生存期为44.1周（四分位距：29.9-80.2），脊髓转移后中位生存期为12.6周（四分位距：5.0-15.0）。三分之二患者接受了脊柱放疗，26.7%接受全身治疗（化疗、靶向治疗和/或免疫治疗），13.3%接受脊柱外科减压术。接受脊柱放疗（风险比：0.61；95%置信区间：0.17-2.23）或全身治疗（风险比：0.94；95%置信区间：0.20-4.39）的患者均未观察到显著的生存获益。 结论：本病例系列研究展示了胶质母细胞瘤脊髓转移患者的临床管理实践与疾病进程。目前尚无治疗模式被证实具有明确优势。治疗仍以姑息性为主，需根据患者个体情况制定个性化方案。
肿瘤(癌症)患者之家