虽然Tokuhashi等[4]认为预期寿命6个月以上是手术治疗的基本要求,我们的资料显示预期寿命在3 ~ 6个月的患者依然可以从手术获益。对于一般情况差,估计生存期少于3个月的患者,不建议外科干预,应为手术禁忌。
至于外科治疗对患者生存期的影响本研究未进行观察,Klimo等[14]在分析既往脊柱转移瘤保守治疗文献后得出保守治疗的脊柱转移瘤患者的1年存活率为20% ~ 28%,平均为24%,本组患者术后1年存活率27%,与前者相似。然而,总体生存期受患者的心理状况、术后放化疗等诸多因素的影响,在今后的研究中将综合考虑外科干预、放化疗以及生物治疗因素等对患者总体生存期的影响。
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