Skip to main content
Log in

Komplexe Knochenmetastasen

Metastasen an der Wirbelsäule interdisziplinär angehen

  • Fortbildung
  • Published:
Orthopädie & Rheuma Aims and scope

Parallel zur gestiegenen Überlebenswahrscheinlichkeit der Patienten mit malignen Tumorerkrankungen stieg in den letzten Jahren auch die Zahl der Patienten mit Metastasen — sehr häufig sind dies komplexe Knochenmetastasen zum Beispiel in der Wirbelsäule. Für diese multidisziplinäre therapeutische Herausforderung bietet das NOMS-Framework einen zuverlässigen Algorithmus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Laufer I, Rubin DG, Lis E, Cox BW, Stubblefield MD, Yamada Y, Bilsky MH. The NOMS framework: approach to the treatment of spinal metastatic tumors. Oncologist 2013;18(6):744–51

    Article  Google Scholar 

  2. Bilsky MH, Laufer I, Fourney DR, et al. Reliability analysis of the epidural spinal cord compression scale. J Neurosurg Spine 2010;13(3):324–8

    Article  Google Scholar 

  3. Patchell RA, Tibbs PA, Regine WF, Payne R, Saris S, Kryscio RJ, Mohiuddin M, Young B. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 2005;366(9486):643–8

    Article  Google Scholar 

  4. Klimo P Jr, Thompson CJ, Kestle JR, Schmidt MH. A meta-analysis of surgery versus conventional radiotherapy for the treatment of metastatic spinal epidural disease. Neuro Oncol 2005;7(1):64–76

    Article  Google Scholar 

  5. Fan Y, et al. The timing of surgical intervention in the treatment of complete motor paralysis in patients with spinal metastasis. Eur Spine J 2016;25(12):4060–6

    Article  Google Scholar 

  6. Bilsky M, Laufer I, Burch S. Shifting paradigms in the treatment of metastatic spine disease. Spine 2009;34:S101–S107

    Article  Google Scholar 

  7. Spratt DE, Beeler WH, de Moraes FY, Rhines LD, Gemmete JJ, Chaudhary N, et al. An integrated multidisciplinary algorithm for the management of spinal metastases: an International Spine Oncology Consortium report. Lancet Oncol 2017;18(12):e720–e730

    Article  Google Scholar 

  8. Yamada Y, Lovelock DM, Yenice KM, et al. Multifractionated image-guided and stereotactic intensity-modulated radiotherapy of paraspinal tumors: a preliminary report. Int J Radiat Oncol Biol Phys 2005;62(1):53–61

    Article  Google Scholar 

  9. Gerszten PC, Burton SA, Ozhasoglu C, Welch WC. Radiosurgery for Spinal Metastases. Spine 2007;32(2):193–9

    Article  Google Scholar 

  10. Yamada Y, Katsoulakis E, Laufer I, et al. The impact of histology and delivered dose on local control of spinal metastases treated with stereotactic radiosurgery. Neurosurg Focus 2017;42(1):E6

    Article  Google Scholar 

  11. Ryu S, Jin J, Jin R, et al. Partial volume tolerance of the spinal cord and complications of single-dose radiosurgery. Cancer 2007;109(3):628–36

    Article  Google Scholar 

  12. Yamada Y, Bilsky MH, Lovelock DM, et al. High-dose, single-fraction image-guided intensity-modulated radiotherapy for metastatic spinal lesions. Int J Radiat Oncol Biol Phys 2008;71(2):484–90

    Article  Google Scholar 

  13. Delaney TF, Chen GT, Mauceri TC, et al. Intraoperative dural irradiation by customized 192iridium and 90yttrium brachytherapy plaques. Int J Radiat Oncol Biol Phys 2003;57(1):239–45

    Article  Google Scholar 

  14. Folkert MR, Bilsky MH, Cohen GN, et al. Intraoperative 32P high-dose rate brachytherapy of the dura for recurrent primary and metastatic intracranial and spinal tumors. Neurosurgery 2012;71(5):1003–11; discussion 1001

    Article  Google Scholar 

  15. Lindeque BGP, Hak DJ, Mauffrey C, Seligson D, Lindeque B. Use of carbon-fiber-reinforced composite implants in orthopedic surgery. Orthopedics 2014;37(12):825–30

    Article  Google Scholar 

  16. Boriani S, Tedesco G, Ming L, Ghermandi R, Amichetti M, Fossati P, Krengli M, Mavilla L, Gasbarrini A. Carbon-fiber-reinforced PEEK fixation system in the treatment of spine tumors: a preliminary report. Eur Spine J 2017; doi: https://doi.org/10.1007/s00586-017-5258-5

    Google Scholar 

  17. Ringel F, Ryang YM, Kirschke JS, Müller BS, Wilkens JJ, Brodard J, Combs SE, Meyer B. Radiolucent Carbon Fiber-Reinforced Pedicle Screws for Treatment of Spinal Tumors: Advantages for Radiation Planning and Follow-Up Imaging. World Neurosurg 2017;105:294–301

    Article  Google Scholar 

  18. Fisher CG, DiPaola CP, Ryken TC, Bilsky MH, Shaffrey CI, Berven SH, Harrop JS, et al. A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group. Spine (Phila Pa 1976). 2010;35(22):E1221–9

    Article  Google Scholar 

  19. Arana E et al. Spanish Back Pain Research Network Task Force for the Improvement of Inter-Disciplinary Management of Spinal Metastasis. Spine J 2016;16(5):591–9

    Article  Google Scholar 

  20. Kim JM, Losina E, Bono CM, Schoenfeld AJ, Collins JE, Katz JN, Harris MB. Clinical outcome of metastatic spinal cord compression treated with surgical excision ± radiation versus radiation therapy alone: a systematic review of literature. Spine (Phila Pa 1976). 2012;37(1):78–84

    Article  CAS  Google Scholar 

  21. Kim CH, Chung CK, Sohn S, Lee S, Park SB. Less invasive palliative surgery for spinal metastases. J Surg Oncol 2013;108(7):499–503

    Article  Google Scholar 

  22. Versteeg AL, Verlaan JJ, de Baat P, Jiya TU, Stadhouder A, Diekerhof CH, et al. Complications After Percutaneous Pedicle Screw Fixation for the Treatment of Unstable Spinal Metastases. Ann Surg Oncol 2016;23(7):2343–9

    Article  Google Scholar 

  23. Hamad A, Vachtsevanos L, Cattell A, Ockendon M, Balain B. Minimally invasive spinal surgery for the management of symptomatic spinal metastasis. Br J Neurosurg 2017;31(5):526–30

    Article  Google Scholar 

  24. Hansen-Algenstaedt N, Kwan MK, Algenstaedt P, Chiu CK, Viezens L, Chan TS, Lee CK, et al. Comparison Between Minimally Invasive Surgery and Conventional Open Surgery for Patients With Spinal Metastasis: A Prospective Propensity Score-Matched Study. Spine (Phila Pa 1976) 2017;42(10):789–97

    Article  Google Scholar 

  25. Berenson J, Pflugmacher R, Jarzem P, et al. Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre, randomised controlled trial. Lancet Oncol 2011;12(3):225–35

    Article  Google Scholar 

  26. Tomita K, Kawahara N, Kobayashi T, Yoshida A, Murakami H, Akamaru T. Surgical strategy for spinal metastases. Spine 2001;26(3):298–306

    Article  CAS  Google Scholar 

  27. Tokuhashi Y, Matsuzaki H, Oda H, Oshima M, Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine 2005;30(19):2186–91

    Article  Google Scholar 

  28. Hibberd CS, Quan GMY. Accuracy of Preoperative Scoring Systems for the Prognostication and Treatment of Patients with Spinal Metastases. Int Sch Res Notices 2017;2017:1320684

    PubMed  PubMed Central  Google Scholar 

  29. Paulino Pereira NR, Janssen SJ, Van Dijk E, et al. Development of a prognostic survival algorithm for patients with metastatic spine disease. J Bone Joint Surg 2016;98(21):1767–76

    Article  Google Scholar 

  30. Paulino Pereira NR, Mclaughlin L, Janssen SJ, et al. The SORG nomogram accurately predicts 3- and 12-months survival for operable spine metastatic disease: external validation. J Surg Oncol 2017;115(8):1019–27

    Article  Google Scholar 

  31. Barzilai O, Fisher CG, Bilsky MH State of the Art Treatment of Spinal Metastatic Disease. Neurosurgery 2018;82(6):757–69

    Article  Google Scholar 

  32. Tobin NP, Foukakis T, De Petris L, Bergh J. The importance of molecular markers for diagnosis and selection of targeted treatments in patients with cancer. J Intern Med. 2015;278(6):545–70

    Article  CAS  Google Scholar 

  33. Goodwin CR, Abu-Bonsrah N, Rhines LD, et al. Molecular markers and targeted therapeutics in metastatic tumors of the spine. Spine 2016;41(suppl 20):S218–S223

    Article  Google Scholar 

  34. Margolin K. The promise of molecularly targeted and immunotherapy for advanced melanoma. Curr Treat Options Oncol 2016;17(9):48

    Article  Google Scholar 

  35. Robert C, Grob JJ, Stroyakovskiy D, Karaszewska B, Hauschild A, Levchenko E, et al. Five Year Outcomes with Dabrafenib plus Trametinib in Metastatic Melanoma. N Engl J Med 2019; doi: https://doi.org/10.1056/NEJMoa1904059. [Epub ahead of print]

  36. Wolchok JD, Chiarion-Sileni V, Gonzalez R, Rutkowski P, Grob JJ, Cowey CL, Lao CD, et al. Overall Survival with Combined Nivolumab and Ipilimumab in Advanced Melanoma. N Engl J Med. 2017;377(14):1345–56

    Article  CAS  Google Scholar 

  37. Gandhi L, Rodríguez-Abreu D, Gadgeel S, Esteban E, Felip E, De Angelis F, Domine M, et al. KEYNOTE-189 Investigators. Pembrolizumab plus Chemotherapy in Metastatic Non-Small-Cell Lung Cancer. N Engl J Med. 2018;378(22):2078–92

    Article  CAS  Google Scholar 

  38. Soria JC, Ohe Y, Vansteenkiste J, Reungwetwattana T, Chewaskulyong B, Lee KH, et al. FLAURA Investigators. Osimertinib in Untreated EGFR-Mutated Advanced Non-Small-Cell Lung Cancer. N Engl J Med 2018;378(2):113–25

    Article  CAS  Google Scholar 

  39. Olaussen KA, Postel-Vinay S. Predictors of chemotherapy efficacy in non-small-cell lung cancer: a challenging landscape. Ann Oncol 2016;27(11):2004–16

    Article  CAS  Google Scholar 

  40. Ghatalia P, Zibelman M, Geynisman DM, Plimack ER. Checkpoint inhibitors for the treatment of renal cell carcinoma. Curr Treat Options Oncol 2017;18(1):7

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ehab Shiban.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shiban, E., Grossert, U., Stemmer, B. et al. Metastasen an der Wirbelsäule interdisziplinär angehen. Orthop. Rheuma 22, 24–32 (2019). https://doi.org/10.1007/s15002-019-1718-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15002-019-1718-0

Navigation