Manejo actual de las metástasis vertebrales: un trabajo en equipo / Current management of vertebral metastases: teamwork

La enfermedad metastásica vertebral es frecuente en los pacientes con cáncer avanzado, y conlleva a complicaciones inherentes a su progresión, como lo son la fractura patológica vertebral y la compresión neural metastásica. Se realizó una revisión de los aspectos terapéuticos actuales del manejo de la progresión y de las complicaciones de la enfermedad metastásica vertebral, enfatizando su enfrentamiento sistémico y personalizado. Nuestro objetivo principal es proporcionar información sobre el tratamiento actual de esta afección y la utilidad del manejo sistémico y multidisciplinario.

Metastatic spinal disease is common in patients with advanced cancer, and leads to complications inherent in its progression, such as pathological vertebral fracture and metastatic neural compression. A review of the current therapeutic aspects regarding the progression and complications of metastatic spinal disease was performed, highlighting its systemic, personalized approach. Our aim is to provide information about the current treatment of this condition and the usefulness of its systemic and multidisciplinary management.

Radiosurgery for Spinal Lesions

Spinal Stereotactic Radiosurgery (SRS) has become an important treatment modality for a broad range of spinal tumors and spinal vascular lesions. Recent clinical acceptance and awareness of the usefulness of spinal radiosurgery has escalated with the development of modern radiosurgical technology. Image-guided navigation systems incorporating non-invasive fiducial tracking and virtual simulation planning systems have made spinal radiosurgery increasingly effective and expanded the range of clinical applications for which it can be effectively used. Additional improvements such as Intensity Modulation and Micro-Multileaf Collimation that allow the accurate modulating and shaping of the radiation beam have also contributed greatly to the ability of clinicians to treat irregular and critically located lesions with greatly reduced collateral risk. Spinal Radiosurgery for spinal tumors can achieve similar clinical results to cranial stereotactic radiosurgery for brain tumors in terms of achieving local tumor control and improving quality of life and survival rates. Stereotactic radiosurgery, which has long been used for the treatment of intracranial lesions, is now recognized to be a viable option for treating spinal tumors and spinal vascular lesions.