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DOI: 10.1055/s-0045-1810031
O avanço da radioterapia no tratamento das lesões metastáticas da coluna
Advances in Radiotherapy in the Treatment of Metastatic Spinal LesionsSuporte Financeiro Os autores declaram que não receberam suporte financeiro de agências dos setores público, privado ou sem fins lucrativos para a realização deste estudo.
Resumo
A doença metastática da coluna vertebral tem se tornado cada vez mais comum por conta do avanço das terapias sistêmicas oncológicas e do aumento na sobrevida geral dos pacientes com câncer. O tratamento dessa enfermidade é paliativo, mas a própria acepção deste termo evoluiu e hoje consiste em um controle melhor e mais efetivo da doença epor períodos mais longos. Enquanto no passado as técnicas cirúrgicas e radioterápicas, principalmente a radioterapia convencional por feixe externo (cEBRT, do inglês conventional external beam radiation therapy), eram ineficazes ou mórbidas para o controle de muitos tipos de tumores, hoje, com o surgimento e avanço da radiocirurgia estereotáxica corporal (SBRT, do inglês stereotactic body radiation therapy), esse cenário mudou drasticamente. A cirurgia para o manejo da doença metastática ainda tem lugar em estratégias associadas com a radioterapia, mas sofreu grande atualização de propósito e técnica. Todavia, apesar de todo o avanço técnico, a radioterapia apresenta toxicidade e efeitos colaterais que precisam ser considerados. Neste artigo, fornecemos revisão atualizada que versa desde o histórico até as inovações no tratamento das metástases vertebrais, com foco em seus benefícios, indicações e impacto clínico.
Abstract
Metastatic spinal disease has become increasingly common due to advances in systemic oncological therapies and the increase in the overall survival of cancer patients. Its treatment is palliative, but the meaning of this term has evolved and, today, consists of better and more effective condition control over longer periods. In the past, surgical and radiotherapy techniques, especially conventional external beam radiation therapy (cEBRT), were ineffective or morbid for controlling many types of tumors. Now, the emergence and advancement of stereotactic body radiation therapy (SBRT) drastically changed this scenario. Surgery for managing metastatic disease remains significant in radiotherapy-associated strategies, but its purpose and technique have undergone major updates. However, despite all technical advances, radiotherapy has toxicity and side effects that warrant consideration. In this article, we provide an updated review covering everything from history to innovations in treating spinal metastases, focusing on their benefits, indications, and clinical impact.
Contribuições dos autores
Cada autor contribuiu individual e significativamente para o desenvolvimento deste artigo: BGMMC: conceitualização, idealização, desenvolvimento e aplicação da metodologia, redação – rascunho original e redação – revisão & edição; ARNSS, CBS e MSM: redação – rascunho original e redação – revisão & edição; CCNF: desenvolvimento e aplicação da metodologia, redação – rascunho original e redação – revisão & edição; AFC: conceitualização, idealização e redação – revisão & edição.
Publikationsverlauf
Eingereicht: 05. Februar 2025
Angenommen: 26. April 2025
Artikel online veröffentlicht:
18. August 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil
Brian Guilherme Monteiro Marta Coimbra, Alice Roxo Nobre de Souza e Silva, Cauã Bhering Soares, Caio César Nogueira de Figueiredo, Manuel Salvado Macamo, Alexandre Fogaça Cristante. O avanço da radioterapia no tratamento das lesões metastáticas da coluna. Rev Bras Ortop (Sao Paulo) 2025; 60: s00451810031.
DOI: 10.1055/s-0045-1810031
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