Abstract:
The skeleton is the third most common organ system to be involved in the spread of metastatic carcinomas. More options for systemic therapies, surgeries and adjuvant treatments are providing longer survival for patients with known metastatic carcinoma to the bone. This means more patients are living with metastatic skeletal disease than ever before. If metastatic disease results in enough bone loss it can cause significant pain and dysfunction for patients. The acetabulum and pelvis are common sites of metastatic disease. The complex anatomy of the bony pelvis and acetabulum, as well as its proximity to important neurovascular and pelvic structures, can make surgical management of acetabular metastatic disease technically difficult. Decision making for patients with symptomatic skeletal metastatic disease is complex, and multidisciplinary teams can be helpful in providing appropriate care for these patients. Systemic chemotherapies, immunotherapies or targeted therapies may not adequately treat large areas of metastatic disease in the hip and pelvis. Radiation therapy is not successful for all patients. Fortunately, there are evolving therapies that are giving patients and providers more options for treatment. This review article will cover some of those new therapies and their outcomes, focusing on newer ablative, minimally invasive and surgical reconstruction techniques for metastatic disease involving the acetabulum. Decision making in the management of a patient\'s metastatic acetabular disease is still made on a case by case basis. This review article hopefully will remind clinicians of the variety of treatments available to these patients.
摘要:
骨骼是参与转移癌扩散的第三大常见器官系统。系统治疗的更多选择,手术和辅助治疗为已知骨转移癌的患者提供了更长的生存期。这意味着比以往任何时候都更多的患者患有转移性骨骼疾病。如果转移性疾病导致足够的骨丢失,则可能导致患者明显的疼痛和功能障碍。髋臼和骨盆是转移性疾病的常见部位。骨性骨盆和髋臼的复杂解剖结构,以及它靠近重要的神经血管和骨盆结构,可以使髋臼转移性疾病的手术治疗技术难度。有症状的骨转移病患者的决策是复杂的,多学科团队可以帮助为这些患者提供适当的护理。全身化疗,免疫疗法或靶向疗法可能无法充分治疗髋关节和骨盆的大面积转移性疾病.放射治疗并非对所有患者都成功。幸运的是,不断发展的疗法为患者和提供者提供了更多的治疗选择。这篇综述文章将涵盖一些新疗法及其结果,专注于新的烧蚀,涉及髋臼的转移性疾病的微创和外科重建技术。在患者的转移性髋臼疾病的管理中,决策仍然是根据具体情况做出的。这篇综述文章希望能提醒临床医生这些患者可用的各种治疗方法。