Therapeutic efficacy of surgery combined with radiotherapy for spinal metastasis of glioma:a retrospective analysis based on literature and case reports
GONG Liudong
WANG Xiaoxiong
WANG Haiyang
YANG Mingchun
WU Li
LI Guanhao
CHEN Guanxi
ZHANG Na
RAO Xianfeng
CHEN Hao
TENG Lei
Abstract：Objective To characterize secondary spinal cord metastasis(SCM)from intracranial gliomas and to evaluate the association between different treatment combinations and post-SCM survival.Methods The clinical course and management of 2 patients with glioblastoma(GBM)who developed SCM after surgery were analyzed retrospectively.A systematic review of SCM cases was performed following preferred reporting items for systematic reviews and meta-analyses(PRISMA)guidelines(searches conducted up to October 2024).Demographic data,primary tumor characteristics,treatment modalities,and survival outcomes were extracted from included cases.Kaplan-Meier analysis and Log-rank tests were used to compare post-SCM overall survival(post-SCM OS)across different treatment combinations.Results Two SCM patients were female with isocitrate dehydrogenase(IDH)wildtype GBM and developed SCM after standard multimodal therapy.One patient presented with multiple intramedullary segmental lesions and an intraspinal mass at T5-T6 six months post-surgery,experienced short-term remission after concurrent chemoradiotherapy and bevacizumab,but subsequently died from intracranial dissemination.The other patient developed a T7-T8 extramedullary subdural lesion on the background of intracranial recurrence with residual disease;gross total resection was achieved without perioperative complications,and histopathology and molecular profiling were concordant with the primary GBM,confirming secondary SCM.The systematic review included 79 SCM patients with a median age of 43 years;63.3%were male.The primary tumors were predominantly located in the temporal lobe(50.6%),with GBM being the most common pathological type(75.9%).The median interval from initial diagnosis to SCM was 8 months,and the median overall survival after SCM diagnosis was only 3 months.Survival analysis revealed that treatment modality significantly influenced prognosis(χ2=20.02,P=0.005 5),with the surgery-plus-radiotherapy group(without concurrent chemotherapy)demonstrating the longest median survival(9 months).Notably,the addition of chemotherapy to surgery and radiotherapy did not further prolong survival(median survival:3 months;χ2=6.812,P=0.0091).Conclusions SCM carries a dismal prognosis.For patients with high-grade glioma and high-risk features such as ventricular/subventricular zone(SVZ)involvement or intraoperative ventricular entry(VE),spinal MRI should be performed promptly when spinal cord-related symptoms arise during follow-up that cannot be explained by the primary lesion;whole neuraxis imaging may be warranted when indicated.After SCM is confirmed,surgery combined with radiotherapy may be associated with longer post-metastasis survival,whereas the decision to add chemotherapy should be individualized based on disease status and treatment tolerance.
Keywords：gliomaspinal cord metastasissurgery combined with radiotherapyKaplan-Meier survival analysisclinical prognosis
Publication Date：2026-01-20
Online Publishing Date：2026-02-07(First online date of this platform, not the publication date of the document)
Pages：7( 14-20 )