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TheNOMSFramework:ApproachtotheTreatmentofSpinalMetastaticTumors
Background
NOMS框架:脊柱转移性肿瘤的治疗方法
BackgroundSpinalmetastasesfrequentlyariseinpatientswithcancer.Modernoncologyprovidesnumeroustreatmentoptionsthatincludeeffectivesystemic,radiation,andsurgicaloptions.Wedelineateandprovidetheevidencefortheneurologic,oncologic,mechanical,andsystemic(NOMS)decisionframework,whichisusedatMemorialSloan-KetteringCancerCentertodeterminetheoptimaltherapyforpatientswithspinemetastases.
MethodsWeprovidealiteraturereviewoftheintegralpublicationsthatserveasthebasisfortheNOMSframeworkandreporttheresultsofsystematicimplementationoftheNOMSguidedtreatment.
ResultsTheNOMSdecisionframeworkconsistsoftheneurologic,oncologic,mechanical,andsystemicconsiderationsandincorporatestheuseofconventionalexternalbeamradiation,spinalstereotacticradiosurgery,andminimallyinvasiveandopensurgicalinterventions.Reviewofradiationoncologyandsurgicalliteraturethatexaminetheout
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