Can thoracic neurogenic tumors be treated?

Thoracic neurogenic tumors are not incurable. Most patients can achieve favorable outcomes with standardized treatment, but therapeutic strategies must be individualized.

Surgery remains the primary treatment approach. For benign or localized malignant lesions that can be safely dissected, complete resection is preferred to relieve spinal cord and nerve root compression. When tumors are large or adjacent to critical structures, partial debulking may be performed initially, followed by additional treatments. Early postoperative neurofunctional rehabilitation under the guidance of a physical therapist helps minimize long-term sequelae.

For residual, recurrent, or unresectable malignant lesions, radiotherapy can significantly delay disease progression. Modern intensity-modulated radiation therapy (IMRT) allows precise delivery of high-dose radiation to the target area, greatly reducing risks of skin and spinal cord injury. When pathology indicates radiation-sensitive types such as schwannomas, the therapeutic effect is more reliable.

Chemotherapy is primarily used for highly aggressive or metastatic cases. Agents such as cisplatin and etoposide help control systemic micrometastases, though close monitoring for bone marrow suppression and gastrointestinal toxicity is required. For patients with specific genetic mutations, targeted therapies like imatinib can inhibit tumor signaling pathways while sparing normal tissues; molecular testing is mandatory before initiating such treatments.

Complex cases often require multidisciplinary management: neoadjuvant therapy preoperatively to shrink the tumor, adjuvant concurrent chemoradiotherapy postoperatively to eliminate residual disease, and maintenance targeted therapy for consolidation. Throughout the course, imaging and neurophysiological evaluations should be performed every three to six months to detect early signs of recurrence.

Patients should maintain spinal stability in daily life, avoiding heavy lifting and vigorous twisting motions. Nutrition should emphasize high-quality protein and adequate vitamins to support nerve regeneration. With physician approval, gradual core muscle strengthening exercises can enhance spinal support. Any new-onset pain, sensory loss, or motor deficits warrant immediate medical evaluation.