RESUMO
This article is a summary of the revised Dutch multidisciplinary evidence-based guideline 'Spinal metastases' (English translation available at: https://www.oncoline.nl/spinal-metastases) that was published at the end of 2015. This summary provides an easy-to-use overview for physicians to use in their daily practice.
Assuntos
Guias de Prática Clínica como Assunto , Neoplasias da Medula Espinal/secundário , Neoplasias da Coluna Vertebral/secundário , Corticosteroides/uso terapêutico , Antineoplásicos/uso terapêutico , Conservadores da Densidade Óssea/uso terapêutico , Terapia Combinada , Gerenciamento Clínico , Humanos , Neoplasias Primárias Desconhecidas , Países Baixos , Neuroimagem/métodos , Procedimentos Neurocirúrgicos , Cuidados Paliativos/métodos , Cuidados Paliativos/normas , Educação de Pacientes como Assunto , Seleção de Pacientes , Prognóstico , Ablação por Radiofrequência , Radioterapia/métodos , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/terapia , Neoplasias da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/terapia , Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias da Coluna Vertebral/terapia , Vertebroplastia/métodosRESUMO
Here, we describe the development of a Dutch national guideline on metastases and hematological malignancies localized within the spine. The aim was to create a comprehensive guideline focusing on proactive management of these diseases, enabling healthcare professionals to weigh patient perspectives, life expectancy, and expected outcomes to make informed treatment recommendations. A national multidisciplinary panel consisting of clinicians, a nurse, a patient advocate, an epidemiologist, and a methodologist drafted the guideline. The important role of patients in the realization of the guideline enabled us to identify and address perceived shortcomings in patient care. The guideline covers not only metastatic epidural spinal cord compression, but also the treatment of uncomplicated metastases and hematological malignancies localized within the spine. The guideline is applicable in daily practice and provides an up-to-date and concise overview of the diagnostic and treatment possibilities for patients suffering from a disease that can have a serious impact on their quality of life. Suggestions for the practical implementation of patient care in hospitals are also provided, including approaches for pursuing proactive management. The crucial role of the patient in decision making is emphasized in this guideline.
Assuntos
Medicina Baseada em Evidências , Neoplasias Hematológicas/terapia , Comunicação Interdisciplinar , Guias de Prática Clínica como Assunto/normas , Neoplasias da Coluna Vertebral/terapia , Gerenciamento Clínico , Neoplasias Hematológicas/patologia , Humanos , Expectativa de Vida , Qualidade de Vida , Neoplasias da Coluna Vertebral/secundárioRESUMO
Recently, the evidence-based guideline 'Spinal metastasis' produced by the Dutch National Working Group on Neuro-Oncology appeared. This guideline applies to patients with spinal metastases and spinal localizations of haematological malignancies, with or without epidural extension. Timely diagnosis and treatment of spinal metastases is essential in order to reduce pain and neurological deficit in particular. An important aim of this guideline is to reduce both patient and doctor delay by providing information to high-risk patients and their general practitioners and to give clear advice on the organization of care. In this case report we describe two patients with spinal metastases in order to illustrate the difficulties in providing a timely diagnosis and optimal treatment for symptomatic spinal metastases. Furthermore, we provide advice to all health care professionals involved to secure the highest possible quality of life for patients with spinal metastases.
