UNASSIGNED: To analyze clinical outcomes of surgical treatment and prognostic factors of local failure after stereotactic body radiation therapy (SBRT) in patients with spinal metastatic non-small-cell lung cancer (NSCLC).
UNASSIGNED: This study included patients with metastatic spinal cord compression (MSCC) from spinal NSCLC after radiotherapy who received massive spondylectomy for circumferential decompression of spinal cord and reconstruction of spinal stability in our center between May 2006 and February 2017. Neurological function was evaluated using the Frankel score. Overall survival (OS) was estimated by the Kaplan-Meier method. Factors with Pvalues ≤.1 were subjected to multivariate analysis for OS by proportional hazard analysis. Values of P<.05 were considered statistically significant.
UNASSIGNED: The mean age of the 55 included patients (36 male and 19 female) was 57.76 ± 8.94 (median 58, range 36-77) years, with a mean postoperative OS of 14.98 ± 14.81 (median 10.0, range 1-84) months. Neurological function was improved in 46 (83.6%) of the 55 patients after surgery. Prognostic analysis suggested that preoperative frankel score (FS) score, visceral metastasis, D-dimer (D-D) level, and neutrophil/lymphocyte ratio (NLR) were independent prognostic factors for selected patients.
UNASSIGNED: Massive spondylectomy could provide circumferential decompression and improve the neurological function of patients with MSCC from spinal NSCLC after radiotherapy. A preoperative FS score of C/D, no visceral metastasis, D-D <1000 μg/L, and NLR <5 are predictors of better prognosis.
■分析脊柱转移性非小细胞肺癌(NSCLC)患者行立体定向放疗(SBRT)术后局部失败的临床疗效及预后因素。
■这项研究纳入了2006年5月至2017年2月在我们中心接受大规模脊椎切除术以进行脊髓周向减压和重建脊柱稳定性的脊柱非小细胞肺癌放疗后转移性脊髓压迫(MSCC)患者。使用Frankel评分评估神经功能。通过Kaplan-Meier方法估计总生存期(OS)。P值≤.1的因素通过比例风险分析对OS进行多变量分析。P<0.05的值被认为具有统计学意义。
■55名患者(36名男性和19名女性)的平均年龄为57.76±8.94(中位数58,范围36-77)岁,术后平均OS为14.98±14.81(中位数10.0,范围1-84个月)。55例患者中46例(83.6%)术后神经功能得到改善。预后分析提示术前Frankel评分(FS),内脏转移,D-二聚体(D-D)水平,中性粒细胞/淋巴细胞比值(NLR)是入选患者的独立预后因素.
■对于脊柱非小细胞肺癌MSCC患者放疗后,大规模脊椎切除术可以提供圆周减压和改善神经功能。术前FS评分C/D,无内脏转移,D-D<1000μg/L,NLR<5是预后较好的预测因子。