2021 Volume 12 Issue 9 Pages 1194-1201
Introduction: Lung cancer is histologically divided into two main types: non-small cell lung cancer (NSCLC) and small cell lung cancer. NSCLC accounts for approximately 85%-90% of all lung cancers. NSCLC frequently shows spinal metastasis, most of which are osteolytic lesions. Therefore, therapeutic intervention by a spine surgeon for spinal metastasis of NSCLC is crucial to prevent the development of new skeletal-related events (SREs). Lung cancer treatment has rapidly advanced with molecularly targeted drugs. Long-term survival of patients with lung cancer in the advanced stage treated with molecularly targeted drugs can be expected. We investigated the effects of multidisciplinary therapy mainly comprising molecularly targeted drugs against spinal metastasis of NSCLC.
Methods: Twenty-seven patients were diagnosed with NSCLC, of which 21, 5, and 1 patients were with adenocarcinoma, squamous cell carcinoma, and large cell carcinoma, respectively. Patients were divided into groups according to the methods of treatment against spinal metastasis of NSCLC. We investigated the image changes and frequency of SREs before and after treatment to identify the effect of molecularly targeted drugs on the lytic lesions of spinal metastasis of NSCLC.
Results: Of all patients with spinal metastasis of NSCLC, 85.2% had osteolytic lesions and some SREs in the first medical examination. All patients who were treated with molecularly targeted drugs showed an outstanding osteoblastic change in lytic lesions 3 months after starting treatment. No patients showed new SREs.
Conclusions: Molecularly targeted drugs exhibited a remarkable effect on spinal metastasis of NSCLC. It is considered that this effect contributed to a prevention of new SREs.
