脊椎轉移腫瘤的診斷與治療

Diagnosis and Treatment of Spinal Metastasis

賴昆鴻(Kun-Hung Lai) ； 楊榮森(Rong-Sen Yang)

《台灣醫學》 19卷4期 (2015/07) Pp. 402-412

https://doi.org/10.6320/FJM.2015.19(4).11

摘要

因為影像診斷與癌症治療的進步，癌症轉移病人平均五年存活率得以延長， 然而脊椎轉移的發生率與盛行率也較以往上升，病人須要面對脊椎轉移所引發的更多症狀，包含疼痛、麻木、無力、甚至癱瘓等，因此病患對於脊椎轉移的治療需求也較以往更為重要。早期研究發現，早期治療可以帶來較好的生活品質與預後。現在雖然有許多的治療方式可供使用，卻因疾病本身的細胞學、患者本身合併的慢性疾病、年齡、疾病蔓延程度、剩餘餘命等多重因素，無法建立一個明確的治療指引或流程。本文搜尋標題有關脊椎轉移診斷及治療的文獻，對脊椎腫瘤轉移的診斷、藥物治療、手術治療計畫進行簡單討論。脊椎腫瘤轉移的治療須要跨科別共同合作，並針對每個病人的情形加以量身訂做才能增進療效。

關鍵字

腫瘤轉移 ； 脊椎 ； 脊髓壓迫

並列摘要

With the development in image detecting system and evolution in cancer treatment, the 5-year survival rate of cancer patients is increasing. Meanwhile, the prevalence and incidence of spinal metastases are also rising, and patients would face more metastatic related symptoms, including pain, numbness, weakness and even paralysis. There is a greater need for spinal metastases treatment. Early detection and early treatment would lead to better quality of life and outcome. However, there are lots of treatment options currently available for spinal metastases, but no definite guideline of algorithm has been established due to multiple factors including primary histology, existing co-morbidities, patient's age and performance status, disease extent, life expectancy. We reviewed articles focusing on the diagnosis and treatment of spinal metastases, and discussed about the diagnosis methods, pharmacological treatment, as well as surgical planning and treatment. The treatment of spinal metastases requires interdisciplinary collaboration and should be tailor-made according to individual patient's condition.

並列關鍵字

Tumor metastases ； spine ； spinal compression

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