目的 探讨重组人p53腺病毒(recombinant human p53 adenovirus, rAd-p53)在脊柱转移瘤的治疗中的近期疗效。 方法 2006年6月-2009年8月，以经皮注射rAd-p53联合放疗及单独放疗方法治疗肺鳞状细胞癌来源脊柱转移瘤患者各18例，通过比较两组治疗前后的肿瘤体积变化评价疗效，观察两组治疗后肿瘤细胞坏死率情况，检测P53蛋白在癌组织中的表达以及血清中抗特异p53基因腺病毒抗体水平。 结果 联合治疗组疗效评定有效率为66.7%，高于单独放疗组的27.8%，差异有统计学意义(Plt;0.05)。联合治疗组可见明显肿瘤细胞坏死、P53蛋白表达阳性及血清中抗特异p53基因腺病毒抗体水平强阳性。 结论 rAd-p53基因治疗能抑制肿瘤生长，联合放疗可弥补单一放疗的不足，提高放疗的敏感性，有效治疗脊柱转移瘤。
Spine is a common site of metastasis in patients with malignant tumors, and tumor metastasis to the spine can lead to pain, pathological fractures, and nerve compression. In order to optimize the diagnosis and management of patients with spinal metastases and metastatic spinal cord compression (MSCC), the National Institute for Health and Care Excellence (NICE) in the UK proposed the first diagnostic and treatment guidelines for patients with MSCC (or at risk of MSCC) in 2008. In recent years, with the rapid advancement of spinal surgery and radiotherapy technology, the standardized process of MSCC diagnosis and treatment urgently needs to be updated. In 2023, NICE launched new guidelines for spinal metastases and MSCC. Based on a thorough study of the guidelines, this article discusses and interprets pain management, corticosteroid treatment, application of bisphosphonates and denosumab, tools for assessing spinal stability and prognosis, radiation therapy, surgical timing and approach, etc., providing reference for clinical diagnosis and treatment in China.