▲ Professor Younghoon Kim ▲ Professor Hyungyeol Park
[Newsletter of Welfare]Among patients with non-small cell lung cancer metastasis to the spine, a study has been announced that patients with a mutant gene that can be treated with targeted anticancer drugs have a relatively high survival rate, so they should also actively consider spinal metastasis cancer surgery.
70% of cancer patients experience spinal metastases, and in the past, many patients gave up treatment despite severe pain, thinking that metastatic spinal cancer was terminal.
As spinal metastasis progresses, it becomes difficult to move and leads to a decrease in survival rate, so active treatment is considered.
The Catholic University of Korea Seoul St. Mary’s Hospital Orthopedics Professor Kim Young-hoon (corresponding author) team (Eunpyeong St. Mary’s Hospital 1st author Park Hyeong-yeol) selected 22 patients who underwent spinal surgery and radiotherapy combination therapy for spinal metastasis of non-small cell lung cancer from 2011 to 2017 , The patients were compared with 22 patients with similar conditions among 231 patients who received only radiation therapy through trend score matching in a 1:1 ratio considering age, gender, life expectancy, and spinal instability.
As a result of the study, only 5 patients (22.7%) in the radiation treatment group showed worsening of neurological symptoms due to pathologic fractures. Neurological symptoms improved in 2 patients.
In addition, as a result of analyzing the risk factors that affect the survival rate of 44 patients included in the study, it was found that the survival rate was significantly related to the presence of mutations capable of target anticancer drug treatment and the degree of physical activity.
In particular, the average survival rate for patients treated with targeted anticancer drugs was 21 months, whereas for patients treated with conventional anticancer drugs, it was very short at 5 months.
Lung cancer is divided into non-small cell lung cancer and small cell lung cancer in size and shape, and 80-85% are non-small cell lung cancer.
Non-small cell lung cancer metastasizes to the vertebrae through blood or lymph vessels. Metastasis cancer is usually diagnosed in stage 4. Lung cancer treatment for primary cancer and radiation treatment are the first priority for metastasis cancer, but surgical treatment is needed if there is instability of the metastasized vertebrae or if nerve compression causes paralysis.
Unlike normal cancer, which usually worsens at night, pain from metastatic spinal cancer occurs during the day because pain occurs when the vertebrae that support the body move or change posture during the day.
However, since only 10 to 20% of spine metastasis cancer patients have pain, cancer patients need to check for skeletal metastases with whole-body PET-CT or bone scans.
Professor Kim Young-hoon said, “Patients with metastasis of non-small cell lung cancer to the spine are clinically common, but it is not easy to determine a treatment method.” “This study confirmed that it showed the effect of improving gait and neurological symptoms through direct nerve decompression in patients with neurological deficits.”
He continued, “I hope patients with metastatic cancer have hope as treatment technology has developed.” “Patients who were able to receive targeted anticancer treatment had a high average survival rate, and especially when these patients develop neurological deficits or spinal instability, they experience severe pain. Since it leads to hyperparalysis and cannot walk and has to lie down, I hope to actively consider surgical treatment to get rid of pain and overcome cancer.”
Meanwhile, Professor Kim’s team’s research was published in the July issue of ‘Journal of Clinical Medicine’, an international academic journal in the field of clinical medicine.
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2023-08-01 03:01:00
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