DRUG AND RADIATION THERAPY OF METASTATIC SPINAL LESIONS

A.V. Yarikov1-3, O.A. Makeeva4, R.M. Kabardaev5, A.O. Dubskikh6, S.F. Kuznetsov5, A.Yu. Ermolaev7, O.A. Perlmutter2, A.P. Fraerman2, I.I. Smirnov2, A.G. Zabikhova8, A.M. Ermolaeva9, A.G. Sosnin10, A.S. Mukhin11, S.N. Pardaev12, I.V. Gunkin4, R.S. Dzhindzhikhadze7, K.A. Borzov5, S.N. Tsybusov3, A.A. Kalinkin13, A.E. Simonov2, A.O. Kotelnikov14, I.I. Garipov14, M.V. Khomchenkov14

1Privolzhsky district Medical Center FMBA, Nizhny Novgorod

2City Clinical Hospital №39, Nizhny Novgorod

3Lobachevsky National Research Nizhny Novgorod State University, Nizhny Novgorod

4Ogarev Mordovian State University, Saransk

5Blokhin National Medical Research Center of Oncology, Moscow

6Sverdlovsk Regional Oncology Dispensary, Ekaterinburg

7Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow

8Central City Hospital of Arzamas, Arzamas

9Nizhniy Novgorod Regional Clinical Oncology Center, Nizhny Novgorod

10Federal Siberian Scientific and Clinical Center FMBA of Russia, Krasnoyarsk

11Volga Research Medical University, Nizhny Novgorod

12Samarkand branch of the Republican Specialized Scientific and Practical Medical Center of Traumatology and Orthopedics, Uzbekistan, Samarkand

13Siberian Federal Scientific and Clinical Center FMBA of Russia, Seversk

14Ilizarov National Medical Research Center of Traumatology and Orthopedics, Kurgan

Yarikov Anton V. ― Cand. of Sci. (Med.), neurosurgeon/orthopedic traumatologist of Privolzhsky District Medical Center of FMBA, City Clinical Hospital №39

2 Nizhne-Volzhskaya Emb., Nizhny Novgorod, 603001, Russian Federation, e-mail: anton-yarikov@mail.ru, SPIN-code: 8151-2292, ORСID ID: 0000-0002-4437-4480

Abstract. Metastasis of malignant tumors in the spine is a common problem of cancer patients. Modern neuroimaging methods make it possible to identify secondary lesions of the spinal column at an early stage. Currently, the approach to the treatment of metastatic spinal lesions is multidisciplinary and requires the approach of doctors of different specialties: neurosurgeon, radiologist, chemotherapist, neurologist and rehabilitologist. Currently, a combination of several treatment methods is optimal: surgery, radiation and drug therapy. Systemic drug therapy is an integral part of long-term control of spinal metastases and depends on the histological structure of the malignant neoplasm and its ability to respond to drug exposure. The article also describes modern methods of radiation therapy. To date, there is no unity of views and an unambiguous standardized, scientifically based approach to solving the existing problem, however, further study of it will be able to ensure the choice of the optimal algorithm for the curation of patients with metastatic spinal lesion. After all, proper treatment of secondary damage to the spinal column will allow the patient to prevent neurological deficit and persistent pain syndrome, to maintain an optimal quality of life.

Key words: ESCC scale, radionuclide therapy, stereotactic radiation therapy, spinal metastases, local treatment, radiotherapy.