neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2022-24-2-94-104neurosurgery-1202Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWОпухоли позвоночника: обзор литературыSpinal tumors: literature reviewhttps://orcid.org/0000-0002-0925-415XЗакондыринД. Е.ZakondyrinD. E.

Дмитрий Евгеньевич Закондырин

127473, Москва, ул. Делегатская, 20, стр. 1

 

Dmitriy Evgenevich Zakondyrin

Bld. 1, 20 Delegatskaya St., Moscow, 127473

russiandoctor@mail.ruhttps://orcid.org/0000-0003-3515-8329ГриньА. А.GrinA. A.

127473, Москва, ул. Делегатская, 20, стр. 1;

129090, Москва, Большая Сухаревская пл., 3

Bld. 1, 20 Delegatskaya St., Moscow, 127473;

3 Bolshaya Sukharevskaya Sq., Moscow, 129090

ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А. И. Евдокимова» Минздрава РоссииРоссияA.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of RussiaRussian FederationФГБОУ ВО «Московский государственный медико-стоматологический университет им. А. И. Евдокимова» Минздрава России; ГБУЗ «Научно-исследовательский институт скорой помощи им. Н. В. Склифосовского Департамента здравоохранения г. Москвы»РоссияA.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia; N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian Federation20221306202224294104Copyright © Закондырин Д.Е., Гринь А.А., 20222022Закондырин Д.Е., Гринь А.А.Zakondyrin D.E., Grin A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1202

Рассмотрены вопросы эпидемиологии, классификации, диагностики и методов лечения опухолей позвоночника. Приведены данные о частоте встречаемости и особенностях различных гистологических форм доброкачественных и злокачественных новообразований позвонков. Обсуждаются особенности диагностики опухолей позвоночника, классические рентгенографические признаки и современные неинвазивные визуализационные и инвазивные (биопсия) методы. Проанализированы литературные данные о методах и возможностях хирургического лечения. Исследованы современные тенденции в выборе степени радикальности хирургического вмешательства в зависимости от вида опухоли позвоночника с использованием классификаций стадийности новообразований по Ennеking, Weinstein–Boriani–Biagini и Tomita. Уделено внимание современным показаниям к проведению радикальной резекции en bloc на позвоночнике, выполняемой в ограниченном числе случаев. Обсуждаются технологии MISS-хирургии: от вертебропластики, радиочастотной абляции и интервенционного удаления метастатической опухоли до сепарационной хирургии при эпидуральной компрессии. Помимо хирургического лечения, рассматриваются методы неоадъювантной и адъювантной лучевой терапии новообразований позвонков: конвенциальная, конформная, в том числе стереотаксическая, ЛТ и радиохирургия. Представлены данные о современных тенденциях в выборе тактики лечения в зависимости от гистологической природы опухоли, ее радиочувствительности и возможности постлучевой злокачественной трансформации. Медикаментозное лечение, в частности химиотерапия, служит незаменимым методом в лечении вторичных и некоторых первичных злокачественных опухолей позвоночника. Приводятся данные о химиочувствительности различных новообразований и тактике комбинированного и комплексного лечения. Очевидно, что современная тенденция – уменьшение степени хирургической инвазии и выбор в сторону малоинвазивных методов хирургического лечения. При этом сделан вывод, что с учетом биологической природы гемопоэтических опухолей и некоторых сарком позвоночника на современном этапе хирургическое лечение не служит основным методом лечения данных злокачественных новообразований.

Problems epidemiology, classification, diagnosis, and treatment of spinal tumors are considered. Data on morbidity and characteristics of different histological forms of benign and malignant vertebral tumors are presented. Features of spinal tumor diagnosis, classic radiological signs, and current noninvasive visualization and invasive (biopsy) techniques are discussed. Literature data on techniques and capabilities of surgical treatment are analyzed. Current trends in selection of surgical intervention radicality level depending on the type of spinal tumor using staging classifications by Ennеking, Weinstein–Boriani–Biagini and Tomita are described. Current indications for radical en bloc resection performed in a limited number of cases is considered. Minimally invasive spine surgery is discussed: from vertebroplasty, radiofrequency ablation and intervention removal of metastatic tumor to separation surgery for epidural compression. Apart from surgical treatment, neoadjuvant and adjuvant radiotherapy of vertebral tumors are analyzed: conventional, conformal, including stereotaxic, beam therapy and radiosurgery. Data on current trends in treatment selection depending on histological nature of the tumor, its radiosensitivity and probability of post-radiation malignant transformation are presented. Drug treatment, in particular chemotherapy, is an indispensable in treatment of secondary and some primary spinal tumors. Data on chemosensitivity of various tumors and tactics of combination and complex treatment are presented. Evidently, the current trend is to decrease the level of surgical invasiveness and selection of minimally invasive methods of surgical treatment. Moreover, it is concluded that considering the biological nature of hemopoietic tumors and some sarcomas, currently surgical treatment is not the main method of treatment of these malignant tumors.

опухоль позвоночникахирургическое лечениелучевая терапияхимиотерапиянейрохирургияspinal tumorsurgical treatmentradiation therapychemotherapyneurosurgeryReferencesDreghorn C.R., Newman R.J., Hardy G.J., Dickson R.A. Primary tumours of the axial skeleton. Experience of the Leeds Regional Bone Tumour Registry. Spine (Phila Pa 1976) 1990;15(2):137–40. DOI: 10.1097/00007632-199002000-00018.Dreghorn C.R., Newman R.J., Hardy G.J., Dickson R.A. Primary tumours of the axial skeleton. Experience of the Leeds Regional Bone Tumour Registry. Spine (Phila Pa 1976) 1990;15(2):137–40. DOI: 10.1097/00007632-199002000-00018.Ciftdemir M., Kaya M., Selcuk E., Yalniz E. Tumors of the spine World J Orthop 2016;7(2):109–16. DOI: 10.5312/wjo.v7.i2.109.Ciftdemir M., Kaya M., Selcuk E., Yalniz E. Tumors of the spine World J Orthop 2016;7(2):109–16. DOI: 10.5312/wjo.v7.i2.109.Заборовский Н.С., Пташников Д.А., Топузов Э.Э и др. Эпидемиология опухолей позвоночника у пациентов, получивших специализированную ортопедическую помощь. Травматология и ортопедия России 2019;25(1):104–12.Zaborovsky N.S., Ptashnikov D.A., Topuzov E.E. et al. Spine tumor epidemiology in patients who underwent orthopaedic surgery. Travmatologiya i ortopediya Rossii = Traumatology and orthopedics of Russia 2019;25(1):104–12. (In Russ.). DOI: 10.21823/2311-2905-2019-25-1-104-112.Galgano M.A., Goulart C.R., Iwenofu H. et al. Osteoblastomas of the spine: a comprehensive review. Neurosurg Focus 2016;41(2):E4. DOI: 10.3171/2016.5.FOCUS16122.Galgano M.A., Goulart C.R., Iwenofu H. et al. Osteoblastomas of the spine: a comprehensive review. Neurosurg Focus 2016;41(2):E4. DOI: 10.3171/2016.5.FOCUS16122.Mesfin A., McCarthy E.F., Kebaish K.M. Surgical treatment of aneurysmal bone cysts of the spine. Iowa Orthop J 2012;32:40–5.Mesfin A., McCarthy E.F., Kebaish K.M. Surgical treatment of aneurysmal bone cysts of the spine. Iowa Orthop J 2012;32:40–5.Валиев А.К., Соколовский А.В., Неред А.С., Мусаев Э.Р. Малоинвазивные хирургические технологии при поражениях позвоночника в онкогематологии. Клиническая онкогематология 2013;6(2):177–94.Valiyev A.K., Sokolovskiy A.V., Nered A.S., Musaev E.R. Minimally invasive surgical techniques in hematological malignancies with spinal involvement. Klinicheskaya onkogematologiya = Clinical oncohematology 2013;6(2):177–94. (In Russ.).Мусаев Э.Р. Первичные опухоли позвоночника: обзор литературы. Практическая онкология 2010;11(1):19–24.Musayev E.R. Primary spine tumors: a comprehensive review. Prakticheskaya onkologiya = Practical oncology 2010;11(1):19–24 (In Russ.).Cho W., Chang U.-K. Survival and recurrence rate after treatment for primary spinal sarcomas. J Korean Neurosurg Soc 2013;53(4):228–34. DOI: 10.3340/jkns.2013.53.4.228.Cho W., Chang U.-K. Survival and recurrence rate after treatment for primary spinal sarcomas. J Korean Neurosurg Soc 2013;53(4):228–34. DOI: 10.3340/jkns.2013.53.4.228.Гуща А.О., Коновалов Н.А., Арестов С.О и др. Тактика и результаты хирургического лечения пациентов с первичными опухолями позвоночника. Хирургия позвоночника 2015;12(3):72–82.Gushcha A.O., Konovalov N.A., Arestov S.O. et al. Surgical treatment of primary spinal tumors: tactics and results. Hirurgia pozvonocnika = Spine Surgery 2015;12(3):72–82. (In Russ.). DOI: DOI: 10.14531/ss2015.3.72-82.Disch A.C., Kleber C., Redemann D. et al. Current surgical strategies for treating spinal tumors: results of a questionnaire survey among members of the German Spine Society (DWG). Eur J Surg Oncol 2020;46(1):89–94. DOI: 10.1016/j.ejso.2019.08.019.Disch A.C., Kleber C., Redemann D. et al. Current surgical strategies for treating spinal tumors: results of a questionnaire survey among members of the German Spine Society (DWG). Eur J Surg Oncol 2020;46(1):89–94. DOI: 10.1016/j.ejso.2019.08.019.Enneking W.E., Spanier S.S., Goodman M.A. A System for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res 1980;(153):106–20.Enneking W.E., Spanier S.S., Goodman M.A. A System for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res 1980;(153):106–20.Tomasian A., Wallace A.N., Jennings J.W. Benign spine lesions: advancesin techniques for minimally invasive percutaneous treatment. Am J Neuroradiol 2017;38(5):852–61. DOI: 10.3174/ajnr.A5084.Tomasian A., Wallace A.N., Jennings J.W. Benign spine lesions: advancesin techniques for minimally invasive percutaneous treatment. Am J Neuroradiol 2017;38(5):852–61. DOI: 10.3174/ajnr.A5084.Wang B., Meng N., Zhuang Н. et al. The role of radiotherapy and surgery in the management of aggressive vertebral hemangioma: a retrospective study of 20 patients. Med Sci Monit 2018;24:6840–50. DOI: 10.12659/MSM.910439.Wang B., Meng N., Zhuang Н. et al. The role of radiotherapy and surgery in the management of aggressive vertebral hemangioma: a retrospective study of 20 patients. Med Sci Monit 2018;24:6840–50. DOI: 10.12659/MSM.910439.Laredo J.D., Reizine D., Bard M., Merland J.J. Vertebral hemangiomas: radiologic evaluation. Radiology 1986;161(1):183–9. DOI: 10.1148/radiology.161.1.3763864.Laredo J.D., Reizine D., Bard M., Merland J.J. Vertebral hemangiomas: radiologic evaluation. Radiology 1986;161(1):183–9. DOI: 10.1148/radiology.161.1.3763864.Климов В.С., Косимшоев М.А., Евсюков А.В и др. Результаты дифференцированного хирургического лечения агрессивных гемангиом позвонков. Хирургия позвоночника 2018;15(1):79–90.Klimov V.S., Kosimshoev M.A., Evsyukov A.V. et al. Results of differentiated surgical treatment of aggressive vertebral hemangiomas. Hirurgia Pozvonocnika = Spine Surgery 2018;15(1):79–90. (In Russ.)]. DOI: http://dx.doi.org/10.14531/ss2018.1.79-90.Vasudeva V.S., Chi J.H., Groff M.W. Surgical treatment of aggressive vertebral hemangiomas. Neurosurg Focus 2016;41(2):E7. DOI: 10.3171/2016.5.FOCUS16169.Vasudeva V.S., Chi J.H., Groff M.W. Surgical treatment of aggressive vertebral hemangiomas. Neurosurg Focus 2016;41(2):E7. DOI: 10.3171/2016.5.FOCUS16169.Parker J., Soltani S., Boissiere L. et al. Spinal aneurysmal bone cysts (ABCs): optimal management. Orthop Res Rev 2019;11:159–66. DOI: 10.2147/ORR.S211834.Parker J., Soltani S., Boissiere L. et al. Spinal aneurysmal bone cysts (ABCs): optimal management. Orthop Res Rev 2019;11:159–66. DOI: 10.2147/ORR.S211834.Tsagozis P., Brosjo O. Current strategies for the treatment of aneurysmal bone cysts. Orthop Rev (Pavia) 2015;7(4):6182. DOI: 10.4081/or.2015.6182.Tsagozis P., Brosjo O. Current strategies for the treatment of aneurysmal bone cysts. Orthop Rev (Pavia) 2015;7(4):6182. DOI: 10.4081/or.2015.6182.Aiba H., Kobayashi1 M., Waguri-Nagaya Y. et al. Treatment of aneurysmal bone cysts using endoscopic curettage. BMC Musculoskelet Disord 2018;19(1):268. DOI: 10.1186/s12891-018-2176-6.Aiba H., Kobayashi1 M., Waguri-Nagaya Y. et al. Treatment of aneurysmal bone cysts using endoscopic curettage. BMC Musculoskelet Disord 2018;19(1):268. DOI: 10.1186/s12891-018-2176-6.Li G., Fu D., Chen K. et al. Surgical strategy for the management of sacral giant cell tumors: a 32-case series. Spine J 2012;12(6):484–91. DOI: 10.1016/j.spinee.2012.06.014.Li G., Fu D., Chen K. et al. Surgical strategy for the management of sacral giant cell tumors: a 32-case series. Spine J 2012;12(6):484–91. DOI: 10.1016/j.spinee.2012.06.014.Martin С., McCarthy E.F. Giant cell tumor of the sacrum and spinе: series of 23 cases and review of the literature. Iowa Orthop J 2010;30:69–75.Martin С., McCarthy E.F. Giant cell tumor of the sacrum and spinе: series of 23 cases and review of the literature. Iowa Orthop J 2010;30:69–75.Tomita K., Kawahara N., Kobayashi T. et al. Surgical strategy for spinal metastases. Spine (Phila Pa 1976) 2001;26(3):298–306. DOI: 10.1097/00007632-200102010-00016.Tomita K., Kawahara N., Kobayashi T. et al. Surgical strategy for spinal metastases. Spine (Phila Pa 1976) 2001;26(3):298–306. DOI: 10.1097/00007632-200102010-00016.Boriani S. En bloc resection in the spine: a procedure of surgical oncology. J Spine Surg 2018;4(3):668–76. DOI: 10.21037/jss.2018.09.02.Boriani S. En bloc resection in the spine: a procedure of surgical oncology. J Spine Surg 2018;4(3):668–76. DOI: 10.21037/jss.2018.09.02.Boriani S., Weinstein J.N., Biagini R. Primary bone tumors of the spine. Terminology and surgical staging. Spine (Phila Pa 1976) 1997;22(9):1036–44. DOI: 10.1097/00007632-199705010-00020.Boriani S., Weinstein J.N., Biagini R. Primary bone tumors of the spine. Terminology and surgical staging. Spine (Phila Pa 1976) 1997;22(9):1036–44. DOI: 10.1097/00007632-199705010-00020.Tokuhashi Y., Matsuzaki H., Oda H. et al. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976) 2005;30(19):2186–91. DOI: 10.1097/01.brs.0000180401.06919.a5.Tokuhashi Y., Matsuzaki H., Oda H. et al. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976) 2005;30(19):2186–91. DOI: 10.1097/01.brs.0000180401.06919.a5.Pennington Z., Ahmed A.K., Molina C.A. et al. Minimally invasive versus conventional spine surgery for vertebral metastases: a systematic review of the evidence. Ann Transl Med 2018;6(6):103. DOI: 10.21037/atm.2018.01.28.Pennington Z., Ahmed A.K., Molina C.A. et al. Minimally invasive versus conventional spine surgery for vertebral metastases: a systematic review of the evidence. Ann Transl Med 2018;6(6):103. DOI: 10.21037/atm.2018.01.28.Tomita K., Toribatake Y., Kawahara N. et al. Total en bloc spondylectomy and circumspinal decompression for solitary spinal metastasis. Paraplegia 1994;32(1):36–46. DOI: 10.1038/sc.1994.7.Tomita K., Toribatake Y., Kawahara N. et al. Total en bloc spondylectomy and circumspinal decompression for solitary spinal metastasis. Paraplegia 1994;32(1):36–46. DOI: 10.1038/sc.1994.7.Howell E.P., Williamson T., Karikari I. et al. Total en bloc resection of primary and metastatic spine tumors. Ann Transl Med 2019;7(10):226. DOI:10.21037/atm.2019.01.25.Howell E.P., Williamson T., Karikari I. et al. Total en bloc resection of primary and metastatic spine tumors. Ann Transl Med 2019;7(10):226. DOI:10.21037/atm.2019.01.25.Ohashi M., Hirano T., Watanabe K. et al. En bloc spondylectomy for spinal metastases: detailed oncological outcomes at a minimum of 2 years after surgery. Asian Spine J 2019;13(2):296–304. DOI:10.31616/asj.2018.0145.Ohashi M., Hirano T., Watanabe K. et al. En bloc spondylectomy for spinal metastases: detailed oncological outcomes at a minimum of 2 years after surgery. Asian Spine J 2019;13(2):296–304. DOI:10.31616/asj.2018.0145.Deng Z., Xu B., Jin J. et al. Strategies for management of spinal metastases: a comprehensive review. Cancer Translational Medicine 2015;1(3):94–100. DOI: 10.4103/2395-3977.159536.Deng Z., Xu B., Jin J. et al. Strategies for management of spinal metastases: a comprehensive review. Cancer Translational Medicine 2015;1(3):94–100. DOI: 10.4103/2395-3977.159536.Conti A., Acker G., Kluge A. et al. Decision making in patients with metastatic spine. The role of minimally invasive treatment modalities. Front Oncol 2019;9:915. DOI: 10.3389/fonc.2019.00915.Conti A., Acker G., Kluge A. et al. Decision making in patients with metastatic spine. The role of minimally invasive treatment modalities. Front Oncol 2019;9:915. DOI: 10.3389/fonc.2019.00915.Spinazze S., Caraceni A., Schrijvers D. et al. Epidural spinal cord compression. Critical Reviews in Oncology/Hematology 2005;56(3):397–406. DOI: 10.1016/j.critrevonc.2005.04.005.Spinazze S., Caraceni A., Schrijvers D. et al. Epidural spinal cord compression. Critical Reviews in Oncology/Hematology 2005;56(3):397–406. DOI: 10.1016/j.critrevonc.2005.04.005.Bilsky M., Smith M. Surgical approach to epidural spinal cord compression. Hematol Oncol Clin North Am 2006;20(6):1307–17. DOI: 10.1016/j.hoc.2006.09.009.Bilsky M., Smith M. Surgical approach to epidural spinal cord compression. Hematol Oncol Clin North Am 2006;20(6):1307–17. DOI: 10.1016/j.hoc.2006.09.009.Dalbayrak S., Yaman O., Ozer A.F. Minimally invasive approaches in metastatic spinal tumor surgery. Turk Neurosurg 2015;25(3);357–61. DOI: 10.5137/1019-5149.JTN.8990-13.1.Dalbayrak S., Yaman O., Ozer A.F. Minimally invasive approaches in metastatic spinal tumor surgery. Turk Neurosurg 2015;25(3);357–61. DOI: 10.5137/1019-5149.JTN.8990-13.1.Barzilai O., Boriani S., Fisher C.G. et al. Essential concepts for the management of metastatic spine disease: what the surgeon should know and practice. Global Spine J 2019;9(1 Suppl):98S–107S. DOI: 10.1177/2192568219830323.Barzilai O., Boriani S., Fisher C.G. et al. Essential concepts for the management of metastatic spine disease: what the surgeon should know and practice. Global Spine J 2019;9(1 Suppl):98S–107S. DOI: 10.1177/2192568219830323.Goetz M.P., Callstrom M.R., Charboneau J.W. et al. Percutaneous imageguided radiofrequency ablation of painful metastases involving bone: a multicenter study. J Clin Oncol 2004;22(2):300–6. DOI: 10.1200/JCO.2004.03.097.Goetz M.P., Callstrom M.R., Charboneau J.W. et al. Percutaneous imageguided radiofrequency ablation of painful metastases involving bone: a multicenter study. J Clin Oncol 2004;22(2):300–6. DOI: 10.1200/JCO.2004.03.097.Song H.-M., Gu Y.-F., Li Y.-D. et al. Interventional tumor removal: a new technique for malignant spinal tumor and malignant vertebral compression fractures without epidural involvement. Acta Radiol 2014;55(8):976–84. DOI: 10.1177/0284185113508761.Song H.-M., Gu Y.-F., Li Y.-D. et al. Interventional tumor removal: a new technique for malignant spinal tumor and malignant vertebral compression fractures without epidural involvement. Acta Radiol 2014;55(8):976–84. DOI: 10.1177/0284185113508761.Gu Y.-F., Tian Q.-H., Li Y.-D. et al. Percutaneous vertebroplasty and interventional tumor removal for malignant vertebral compression fractures and/or spinal metastatic tumor with epidural involvement: a prospective pilot study. J Pain Res 2017;10:211–8. DOI: 10.2147/JPR.S122211.Gu Y.-F., Tian Q.-H., Li Y.-D. et al. Percutaneous vertebroplasty and interventional tumor removal for malignant vertebral compression fractures and/or spinal metastatic tumor with epidural involvement: a prospective pilot study. J Pain Res 2017;10:211–8. DOI: 10.2147/JPR.S122211.Surgeon’s Committee of the Chinese Myeloma Working Group of the International Myeloma Foundation. Consensus on surgical management of myeloma bone disease. Orthop Surg 2016;8(3):263–9. DOI: 10.1111/os.12267.Surgeon’s Committee of the Chinese Myeloma Working Group of the International Myeloma Foundation. Consensus on surgical management of myeloma bone disease. Orthop Surg 2016;8(3):263–9. DOI: 10.1111/os.12267.Guzik G. Oncological and functional results of the surgical treatment of vertebral metastases in patients with multiple myeloma. BMC Surg 2017;17(1):92. DOI: 10.1186/s12893-017-0288-9.Guzik G. Oncological and functional results of the surgical treatment of vertebral metastases in patients with multiple myeloma. BMC Surg 2017;17(1):92. DOI: 10.1186/s12893-017-0288-9.Peng X., Wan Y., Chen Y. et al. Primary non-Hodgkin’s lymphoma of the spine with neurologic compression treated by radiotherapy and chemotherapy alone or combined with surgical decompression. Oncol Rep 2009;21(5):1269–75. DOI: 10.3892/or_00000350.Peng X., Wan Y., Chen Y. et al. Primary non-Hodgkin’s lymphoma of the spine with neurologic compression treated by radiotherapy and chemotherapy alone or combined with surgical decompression. Oncol Rep 2009;21(5):1269–75. DOI: 10.3892/or_00000350.Harris E., Butler J.S., Cassidy N. Aggressive plasmablastic lymphoma of the thoracic spine presenting as acute spinal cord compression in a case of asymptomatic undiagnosed human immunodeficiency virus infection. Spine J 2014;14(7):e1–5. DOI: 10.1016/j.spinee.2013.12.018.Harris E., Butler J.S., Cassidy N. Aggressive plasmablastic lymphoma of the thoracic spine presenting as acute spinal cord compression in a case of asymptomatic undiagnosed human immunodeficiency virus infection. Spine J 2014;14(7):e1–5. DOI: 10.1016/j.spinee.2013.12.018.Denaro L., Berton A., Ciuffreda M. et al. Surgical management of chordoma: a systematic review. J Spinal Cord Med 2020;43(6):797–812. DOI: 10.1080/10790268.2018.1483593.Denaro L., Berton A., Ciuffreda M. et al. Surgical management of chordoma: a systematic review. J Spinal Cord Med 2020;43(6):797–812. DOI: 10.1080/10790268.2018.1483593.Varga P.P., Szoverfi Z., Fisher C.G. et al. Surgical treatment of sacral chordoma: prognostic variables for local recurrence and overall survival. Eur Spine J 2015;24(5):1092–101. DOI: 10.1007/s00586-014-3728-6.Varga P.P., Szoverfi Z., Fisher C.G. et al. Surgical treatment of sacral chordoma: prognostic variables for local recurrence and overall survival. Eur Spine J 2015;24(5):1092–101. DOI: 10.1007/s00586-014-3728-6.Dekutoski M.B., Clarke M.J., Rose P. et al. Osteosarcoma of the spine: prognostic variables for local recurrence and overall survival, a multicenter ambispective study. J Neurosurg Spine 2016;25:59–68. DOI: 10.3171/2015.11.SPINE15870.Dekutoski M.B., Clarke M.J., Rose P. et al. Osteosarcoma of the spine: prognostic variables for local recurrence and overall survival, a multicenter ambispective study. J Neurosurg Spine 2016;25:59–68. DOI: 10.3171/2015.11.SPINE15870.Charest-Morin R., Dirks M.S., Patel S. et al. Ewing sarcoma of the spine prognostic variables for survival and local control in surgically treated patients. Spine (Phila Pa 1976) 2018;43(9):622–9. DOI: 10.1097/BRS.0000000000002386.Charest-Morin R., Dirks M.S., Patel S. et al. Ewing sarcoma of the spine prognostic variables for survival and local control in surgically treated patients. Spine (Phila Pa 1976) 2018;43(9):622–9. DOI: 10.1097/BRS.0000000000002386.Овчинников В.А., Угляница К.Н., Волков В.Н. Современные методы лучевого лечения онкологических больных. Журнал ГрГМУ 2010;1(29):93–7.Ovchinnikov V.A., Uglyanitsa K.N., Volkov V.N. Modern metods of radiotherapy of oncological patients. Zhurnal GrGMU = Journal of the Grodno State Medical University 2010;1(29):93–7. (In Russ.).Трофимова О.П., Ткачев С.И., Юрьева Т.В. Прошлое и настоящее лучевой терапии в онкологии. Клиническая онкогематология 2013;6(4): 355–64.Trofimova O.P., Tkachev S.I., Yuryeva T.V. Past and present of radiotherapy in management of malignancies. Klinicheskaya onkogematologiya = Clinical oncohematology 2013;6(4): 355–64. (In Russ.).Sharma A.M., Sackett M., Bueddefeld D. et al. Incidence of spinal disease and role of spinal radiotherapy in multiplemyeloma. Curr Oncol 2018;25(6):e539–44. DOI:10.3747/co.25.4188.Sharma A.M., Sackett M., Bueddefeld D. et al. Incidence of spinal disease and role of spinal radiotherapy in multiplemyeloma. Curr Oncol 2018;25(6):e539–44. DOI:10.3747/co.25.4188.Rades D., Сonde-Moreno A.J., Cacicedo J. et al. Radiation therapy alone provides excellent outcomes for spinal cord compression from vertebral lymphoma. Anticancer Res 2016;36:3081–3.Rades D., Сonde-Moreno A.J., Cacicedo J. et al. Radiation therapy alone provides excellent outcomes for spinal cord compression from vertebral lymphoma. Anticancer Res 2016;36:3081–3.Patchell R.A., Tibbs P.A., Regine W.F et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 2005;366(9486):643–8. DOI: 10.1016/S0140-6736(05)66954-1.Patchell R.A., Tibbs P.A., Regine W.F et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 2005;366(9486):643–8. DOI: 10.1016/S0140-6736(05)66954-1.Lee J.-H., Lee S.H. Selecting the appropriate radiation therapy technique for malignant spinal cord compression syndrome. Front Oncol 2019;9:65. DOI: 10.3389/fonc.2019.00065.Lee J.-H., Lee S.H. Selecting the appropriate radiation therapy technique for malignant spinal cord compression syndrome. Front Oncol 2019;9:65. DOI: 10.3389/fonc.2019.00065.Boriani S., Saravanja D., Yamada Y. et al. Challenges of local recurrence and cure in low grade malignant tumors of the spine. Spine (Phila Pa 1976) 2009;34(22 Suppl):S48–57. DOI: 10.1097/brs.0b013e3181b969ac.Boriani S., Saravanja D., Yamada Y. et al. Challenges of local recurrence and cure in low grade malignant tumors of the spine. Spine (Phila Pa 1976) 2009;34(22 Suppl):S48–57. DOI: 10.1097/brs.0b013e3181b969ac.Palm R.F., Oliver D.E., Yang G.Q. et al. The role of dose escalation and proton therapy in perioperative or definitive treatment of chondrosarcoma and chordoma: an analysis of the National Cancer Data Base. Cancer 2019;125(4):642–51. DOI: 10.1002/cncr.31958.Palm R.F., Oliver D.E., Yang G.Q. et al. The role of dose escalation and proton therapy in perioperative or definitive treatment of chondrosarcoma and chordoma: an analysis of the National Cancer Data Base. Cancer 2019;125(4):642–51. DOI: 10.1002/cncr.31958.Chang U.K., Lee D.H., Kim M.S. Stereotactic radiosurgery for primary malignant spinal tumors. Neurol Res 2014;36(6):597–606. DOI: 10.1179/1743132814Y.0000000381.Chang U.K., Lee D.H., Kim M.S. Stereotactic radiosurgery for primary malignant spinal tumors. Neurol Res 2014;36(6):597–606. DOI: 10.1179/1743132814Y.0000000381.Krakoff I.H. Cancer chemotherapeutic agents. CA Cancer J Clin 1977;27(3):130–43.Krakoff I.H. Cancer chemotherapeutic agents. CA Cancer J Clin 1977;27(3):130–43.Tomita N., Takasaki H., Miyashita K. et al. R-CHOP therapy alone in limited stage diffuse large B-cell lymphoma. Br J Haematol 2013;161(3):383–8. DOI: 10.1111/bjh.12281.Tomita N., Takasaki H., Miyashita K. et al. R-CHOP therapy alone in limited stage diffuse large B-cell lymphoma. Br J Haematol 2013;161(3):383–8. DOI: 10.1111/bjh.12281.Алиев М.Д., Бохян А.Ю., Иванов С.М. и др. Клинические рекомендации по диагностике и лечению больных с первичными злокачественными опухолями кости Ассоциации онкологов России. М., 2014. 25 с.Aliev M.D., Bokhyan A.Yu., Ivanov S.M. et al. Clinical recommendations for the diagnosis and treatment of patients with primary malignant bone tumors of the Association of Oncologists of Russia. Moscow, 2014. 25 p. (In Russ.).Makatsoris T., Kalofonos H.P. The role of chemotherapy in the treatment of bone metastases. In: Bone Metastases. Cancer Metastasis – Biology and Treatment. Eds.: D. Kardamakis, V. Vassiliou, E. Chow. Dordrecht: Springer Netherlands, 2009. Pp. 287–98. DOI: https://doi.org/10.1007/978-1-4020-9819-2_14.Makatsoris T., Kalofonos H.P. The role of chemotherapy in the treatment of bone metastases. In: Bone Metastases. Cancer Metastasis – Biology and Treatment. Eds.: D. Kardamakis, V. Vassiliou, E. Chow. Dordrecht: Springer Netherlands, 2009. Pp. 287–98. DOI: https://doi.org/10.1007/978-1-4020-9819-2_14.

The authors declare that there are no conflicts of interest present.