Treatment Outcome of Metastatic Spine Tumor in Lung Cancer Patients: Did the Treatments Improve Their Outcomes?

STUDY DESIGN. A retrospective, single-center study. OBJECTIVE. Investigation of the changes in the treatment outcomes of patients with lung cancer derived metastatic spine tumors. SUMMARY OF BACKGROUND DATA. Metastatic spine tumors derived from lung cancer had been progressive, and their prognosis is poor. It has recently been reported that the use of molecularly targeted drugs and bone-modifying agents (BMAs) improved the treatment outcomes of patients with lung cancer, but no detailed information about the treatment of metastatic spine tumors has been reported. METHODS. Two hundred seven patients with lung cancer derived metastatic spine tumors who were examined after 2000 were analyzed. They were divided into 54 patients who were treated in or before 2005 (surgical treatment: 25 patients, conservative treatment: 29 patients) (group B) and 153 patients who were treated from 2006 onwards, when a molecularly targeted drug and BMA were introduced (surgical treatment: 24, conservative treatment: 129) (group A), and the treatment outcomes of the two groups were compared. RESULTS. Significant differences in age and the affected vertebral level, paralysis grade, and Tokuhashi score (general condition, the number of vertebral metastases, and the total score) were detected between the groups. Regarding treatment outcomes, the mean duration of the post-treatment survival period was 5.1 and 9.3 months in groups B and A, respectively, that is, it was significantly longer in group A (P < 0.05). No significant intergroup difference in pain improvement was noted, and no significant post-treatment improvement in paralysis was achieved in either group. The post-treatment discharge-to-home eligibility rate did not differ significantly between the groups, but the Barthel Index improved significantly after treatment in group A (P < 0.05). CONCLUSION. After molecularly targeted drugs and BMA were introduced as treatments for lung cancer derived metastatic spine tumors, the survival periods of patients with such tumors increased, and their activity of daily living after treatment improved. Level of Evidence: 4