Local treatment approach of metastatic spine in lung cancer patients

Purpose. Improving the results of local treatment of patients with lung cancer metastasis to the spine. Materials and methods. We analyzed the data of 106 patients with metastatic spinal lesions of lung cancer, mean age 55.9 years. The immediate and long-term results of treatment were studied, the prediction factors for the disease were searched for and ranked. Results. One-year survival of patients with lung cancer was 68%, 2-year-old - 25%, 5-year-old - only 3%. The levels of overall survival were not significantly different in adenocarcinoma groups without mutations, small cell and squamous cell carcinomas, and also depending on the method of treatment used. An attempt to use the Tokuhashi, Tomita and Bauer scales in patients with metastases to the spine with an unfavorable cancer prognosis indicated that the use of these prognostic tools was low. It is shown that the most significant for the prognosis in patients with lung cancer with metastases in the spine are such factors as the tumor histological type, molecular genetic features of the tumor, number of lesions, tumor process extent, presence of metastases in the visceral zones, functional state of the patient and number of chemotherapy courses. Obviously, these factors should be taken into account when developing treatment tactics and further monitoring of these patients. Conclusion. Indications for surgical treatment of patients with spine metastases of lung cancer should be determined taking into account the neurological and orthopedic status, as well as the general condition of the patient. Surgical local treatment is advisable to conduct patients with a life expectancy of at least 3-4 months; its volume depends on the expected life expectancy, which can be determined on the basis of individual prognostic factors. For patients with extremely poor prognosis (3 months or less), palliative radiotherapy is indicated in mono regimen. In patients with conditionally favorable oncologic prognosis after surgical local treatment, postoperative radiotherapy has been shown to consolidate the effect.

lung cancer, spine metastases, survival, vertebroplasty, radiation therapy, prognostic factors, spinal surgery, local treatment, bone metastasis, vertebral fracture

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