829 lines
160 KiB
Text
829 lines
160 KiB
Text
<!DOCTYPE html>
|
|
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" class="no-js no-jr">
|
|
<head>
|
|
<!-- For pinger, set start time and add meta elements. -->
|
|
<script type="text/javascript">var ncbi_startTime = new Date();</script>
|
|
|
|
<!-- Logger begin -->
|
|
<meta name="ncbi_db" content="books">
|
|
<meta name="ncbi_pdid" content="book-toc">
|
|
<meta name="ncbi_acc" content="NBK595812">
|
|
<meta name="ncbi_domain" content="niceng234er13">
|
|
<meta name="ncbi_report" content="reader">
|
|
<meta name="ncbi_type" content="fulltext">
|
|
<meta name="ncbi_objectid" content="">
|
|
<meta name="ncbi_pcid" content="/NBK595812/?report=reader">
|
|
<meta name="ncbi_pagename" content="Evidence reviews for radiotherapy - NCBI Bookshelf">
|
|
<meta name="ncbi_bookparttype" content="toc">
|
|
<meta name="ncbi_app" content="bookshelf">
|
|
<!-- Logger end -->
|
|
|
|
<!--component id="Page" label="meta"/-->
|
|
<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Evidence reviews for radiotherapy - NCBI Bookshelf</title>
|
|
<meta charset="utf-8">
|
|
<meta name="apple-mobile-web-app-capable" content="no">
|
|
<meta name="viewport" content="initial-scale=1,minimum-scale=1,maximum-scale=1,user-scalable=no">
|
|
<meta name="jr-col-layout" content="1">
|
|
<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE,NOIMAGEINDEX">
|
|
<meta name="citation_title" content="Evidence reviews for radiotherapy">
|
|
<meta name="citation_publisher" content="National Institute for Health and Care Excellence (NICE)">
|
|
<meta name="citation_date" content="2023/09">
|
|
<meta name="citation_pmid" content="37824688">
|
|
<meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK595812/">
|
|
<meta name="citation_keywords" content="Spinal Neoplasms">
|
|
<meta name="citation_keywords" content="Spinal Cord Neoplasms">
|
|
<meta name="citation_keywords" content="Spinal Cord Compression">
|
|
<meta name="citation_keywords" content="Neoplasm Metastasis">
|
|
<meta name="citation_keywords" content="Radiotherapy">
|
|
<meta name="citation_keywords" content="Dose Fractionation, Radiation">
|
|
<meta name="citation_keywords" content="Stereotaxic Techniques">
|
|
<meta name="citation_keywords" content="Humans">
|
|
<meta name="citation_keywords" content="Review">
|
|
<link rel="schema.DC" href="http://purl.org/DC/elements/1.0/">
|
|
<meta name="DC.Title" content="Evidence reviews for radiotherapy">
|
|
<meta name="DC.Type" content="Text">
|
|
<meta name="DC.Publisher" content="National Institute for Health and Care Excellence (NICE)">
|
|
<meta name="DC.Date" content="2023/09">
|
|
<meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK595812/">
|
|
<meta name="og:title" content="Evidence reviews for radiotherapy">
|
|
<meta name="og:type" content="book">
|
|
<meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK595812/">
|
|
<meta name="og:site_name" content="NCBI Bookshelf">
|
|
<meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng234er13-lrg.png">
|
|
<meta name="twitter:card" content="summary">
|
|
<meta name="twitter:site" content="@ncbibooks">
|
|
<meta name="bk-non-canon-loc" content="/books/n/niceng234er13/toc/?report=reader">
|
|
<link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK595812/">
|
|
<link href="https://fonts.googleapis.com/css?family=Archivo+Narrow:400,700,400italic,700italic&subset=latin" rel="stylesheet" type="text/css">
|
|
<link rel="stylesheet" href="/corehtml/pmc/jatsreader/ptpmc_3.22/css/libs.min.css">
|
|
<link rel="stylesheet" href="/corehtml/pmc/jatsreader/ptpmc_3.22/css/jr.min.css">
|
|
<meta name="format-detection" content="telephone=no">
|
|
<link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css">
|
|
<link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css//books_print.min.css" type="text/css" media="print">
|
|
<link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_reader.min.css" type="text/css">
|
|
<style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style>
|
|
|
|
<link rel="shortcut icon" href="//www.ncbi.nlm.nih.gov/favicon.ico">
|
|
<meta name="ncbi_phid" content="CE8CF9B57D6C5C910000000000990080.m_5">
|
|
<meta name='referrer' content='origin-when-cross-origin'/><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3852956/3849091.css"></head>
|
|
<body>
|
|
<!-- Book content! -->
|
|
|
|
|
|
<div id="jr" data-jr-path="/corehtml/pmc/jatsreader/ptpmc_3.22/"><div class="jr-unsupported"><table class="modal"><tr><td><span class="attn inline-block"></span><br />Your browser does not support the NLM PubReader view.<br />Go to <a href="/pmc/about/pr-browsers/">this page</a> to see a list of supported browsers<br />or return to the <br /><a href="/books/NBK595812/?report=classic">regular view</a>.</td></tr></table></div><div id="jr-ui" class="hidden"><nav id="jr-head"><div class="flexh tb"><div id="jr-tb1"><a id="jr-links-sw" class="hidden" title="Links"><svg xmlns="http://www.w3.org/2000/svg" version="1.1" x="0px" y="0px" viewBox="0 0 70.6 85.3" style="enable-background:new 0 0 70.6 85.3;vertical-align:middle" xml:space="preserve" width="24" height="24">
|
|
<style type="text/css">.st0{fill:#939598;}</style>
|
|
<g>
|
|
<path class="st0" d="M36,0C12.8,2.2-22.4,14.6,19.6,32.5C40.7,41.4-30.6,14,35.9,9.8"></path>
|
|
<path class="st0" d="M34.5,85.3c23.2-2.2,58.4-14.6,16.4-32.5c-21.1-8.9,50.2,18.5-16.3,22.7"></path>
|
|
<path class="st0" d="M34.7,37.1c66.5-4.2-4.8-31.6,16.3-22.7c42.1,17.9,6.9,30.3-16.4,32.5h1.7c-66.2,4.4,4.8,31.6-16.3,22.7 c-42.1-17.9-6.9-30.3,16.4-32.5"></path>
|
|
</g>
|
|
</svg> Books</a></div><div class="jr-rhead f1 flexh"></div><div id="jr-tb2"><a id="jr-bkhelp-sw" class="btn wsprkl hidden" title="Help with NLM PubReader">?</a><a id="jr-help-sw" class="btn wsprkl hidden" title="Settings and typography in NLM PubReader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512" preserveAspectRatio="none"><path d="M462,283.742v-55.485l-29.981-10.662c-11.431-4.065-20.628-12.794-25.274-24.001 c-0.002-0.004-0.004-0.009-0.006-0.013c-4.659-11.235-4.333-23.918,0.889-34.903l13.653-28.724l-39.234-39.234l-28.72,13.652 c-10.979,5.219-23.68,5.546-34.908,0.889c-0.005-0.002-0.01-0.003-0.014-0.005c-11.215-4.65-19.933-13.834-24-25.273L283.741,50 h-55.484l-10.662,29.981c-4.065,11.431-12.794,20.627-24.001,25.274c-0.005,0.002-0.009,0.004-0.014,0.005 c-11.235,4.66-23.919,4.333-34.905-0.889l-28.723-13.653l-39.234,39.234l13.653,28.721c5.219,10.979,5.545,23.681,0.889,34.91 c-0.002,0.004-0.004,0.009-0.006,0.013c-4.649,11.214-13.834,19.931-25.271,23.998L50,228.257v55.485l29.98,10.661 c11.431,4.065,20.627,12.794,25.274,24c0.002,0.005,0.003,0.01,0.005,0.014c4.66,11.236,4.334,23.921-0.888,34.906l-13.654,28.723 l39.234,39.234l28.721-13.652c10.979-5.219,23.681-5.546,34.909-0.889c0.005,0.002,0.01,0.004,0.014,0.006 c11.214,4.649,19.93,13.833,23.998,25.271L228.257,462h55.484l10.595-29.79c4.103-11.538,12.908-20.824,24.216-25.525 c0.005-0.002,0.009-0.004,0.014-0.006c11.127-4.628,23.694-4.311,34.578,0.863l28.902,13.738l39.234-39.234l-13.66-28.737 c-5.214-10.969-5.539-23.659-0.886-34.877c0.002-0.005,0.004-0.009,0.006-0.014c4.654-11.225,13.848-19.949,25.297-24.021 L462,283.742z M256,331.546c-41.724,0-75.548-33.823-75.548-75.546s33.824-75.547,75.548-75.547 c41.723,0,75.546,33.824,75.546,75.547S297.723,331.546,256,331.546z"></path></svg></a><a id="jr-fip-sw" class="btn wsprkl hidden" title="Find"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 550 600" preserveAspectRatio="none"><path fill="none" stroke="#000" stroke-width="36" stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-cmap-sw" class="btn wsprkl hidden" title="Table of Contents"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M20,20h10v8H20V20zM36,20h44v8H36V20zM20,37.33h10v8H20V37.33zM36,37.33h44v8H36V37.33zM20,54.66h10v8H20V54.66zM36,54.66h44v8H36V54.66zM20,72h10v8 H20V72zM36,72h44v8H36V72z"></path></svg></a></div></div></nav><nav id="jr-dash" class="noselect"><nav id="jr-dash" class="noselect"><div id="jr-pi" class="hidden"><a id="jr-pi-prev" class="hidden" title="Previous page"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a><div class="pginfo">Page <i class="jr-pg-pn">0</i> of <i class="jr-pg-lp">0</i></div><a id="jr-pi-next" class="hidden" title="Next page"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div><div id="jr-is-tb"><a id="jr-is-sw" class="btn wsprkl hidden" title="Switch between Figures/Tables strip and Progress bar"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><rect x="10" y="40" width="20" height="20"></rect><rect x="40" y="40" width="20" height="20"></rect><rect x="70" y="40" width="20" height="20"></rect></svg></a></div><nav id="jr-istrip" class="istrip hidden"><a id="jr-is-prev" href="#" class="hidden" title="Previous"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M80,40 60,65 80,90 70,90 50,65 70,40z M50,40 30,65 50,90 40,90 20,65 40,40z"></path><text x="35" y="25" textLength="60" style="font-size:25px">Prev</text></svg></a><a id="jr-is-next" href="#" class="hidden" title="Next"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M20,40 40,65 20,90 30,90 50,65 30,40z M50,40 70,65 50,90 60,90 80,65 60,40z"></path><text x="15" y="25" textLength="60" style="font-size:25px">Next</text></svg></a></nav><nav id="jr-progress"></nav></nav></nav><aside id="jr-links-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">NCBI Bookshelf</div></div><div class="cnt lol f1"><a href="/books/">Home</a><a href="/books/browse/">Browse All Titles</a><a class="btn share" target="_blank" rel="noopener noreferrer" href="https://www.facebook.com/sharer/sharer.php?u=https://www.ncbi.nlm.nih.gov/books/NBK595812/"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 33 33" style="vertical-align:middle" width="24" height="24" preserveAspectRatio="none"><g><path d="M 17.996,32L 12,32 L 12,16 l-4,0 l0-5.514 l 4-0.002l-0.006-3.248C 11.993,2.737, 13.213,0, 18.512,0l 4.412,0 l0,5.515 l-2.757,0 c-2.063,0-2.163,0.77-2.163,2.209l-0.008,2.76l 4.959,0 l-0.585,5.514L 18,16L 17.996,32z"></path></g></svg> Share on Facebook</a><a class="btn share" target="_blank" rel="noopener noreferrer" href="https://twitter.com/intent/tweet?url=https://www.ncbi.nlm.nih.gov/books/NBK595812/&text=Evidence%20reviews%20for%20radiotherapy"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 33 33" style="vertical-align:middle" width="24" height="24"><g><path d="M 32,6.076c-1.177,0.522-2.443,0.875-3.771,1.034c 1.355-0.813, 2.396-2.099, 2.887-3.632 c-1.269,0.752-2.674,1.299-4.169,1.593c-1.198-1.276-2.904-2.073-4.792-2.073c-3.626,0-6.565,2.939-6.565,6.565 c0,0.515, 0.058,1.016, 0.17,1.496c-5.456-0.274-10.294-2.888-13.532-6.86c-0.565,0.97-0.889,2.097-0.889,3.301 c0,2.278, 1.159,4.287, 2.921,5.465c-1.076-0.034-2.088-0.329-2.974-0.821c-0.001,0.027-0.001,0.055-0.001,0.083 c0,3.181, 2.263,5.834, 5.266,6.438c-0.551,0.15-1.131,0.23-1.73,0.23c-0.423,0-0.834-0.041-1.235-0.118 c 0.836,2.608, 3.26,4.506, 6.133,4.559c-2.247,1.761-5.078,2.81-8.154,2.81c-0.53,0-1.052-0.031-1.566-0.092 c 2.905,1.863, 6.356,2.95, 10.064,2.95c 12.076,0, 18.679-10.004, 18.679-18.68c0-0.285-0.006-0.568-0.019-0.849 C 30.007,8.548, 31.12,7.392, 32,6.076z"></path></g></svg> Share on Twitter</a></div></aside><aside id="jr-cmap-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">In Page Navigation</div></div><div class="cnt lol f1"><a href="/books/n/niceercollect/?report=reader">NICE Evidence Reviews Collection</a><a class="current">Title Information</a></div></aside><aside id="jr-help-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">Settings</div></div><div class="cnt f1"><div id="jr-typo-p" class="typo"><div><a class="sf btn wsprkl">A-</a><a class="lf btn wsprkl">A+</a></div><div><a class="bcol-auto btn wsprkl"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 200 100" preserveAspectRatio="none"><text x="10" y="70" style="font-size:60px;font-family: Trebuchet MS, ArialMT, Arial, sans-serif" textLength="180">AUTO</text></svg></a><a class="bcol-1 btn wsprkl"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M15,25 85,25zM15,40 85,40zM15,55 85,55zM15,70 85,70z"></path></svg></a><a class="bcol-2 btn wsprkl"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M5,25 45,25z M55,25 95,25zM5,40 45,40z M55,40 95,40zM5,55 45,55z M55,55 95,55zM5,70 45,70z M55,70 95,70z"></path></svg></a></div></div><div class="lol"><a class="" href="/books/NBK595812/?report=classic">Switch to classic view</a><a href="/books/n/niceng234er13/pdf/">PDF (1.3M)</a><a href="/books/n/niceng234er13/toc/?report=printable">Print View</a></div></div></aside><aside id="jr-bkhelp-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">Help</div></div><div class="cnt f1 lol"><a id="jr-helpobj-sw" data-path="/corehtml/pmc/jatsreader/ptpmc_3.22/" data-href="/corehtml/pmc/jatsreader/ptpmc_3.22/img/bookshelf/help.xml" href="">Help</a><a href="mailto:info@ncbi.nlm.nih.gov?subject=PubReader%20feedback%20%2F%20NBK595812%20%2F%20sid%3ACE8B5AF87C7FFCB1_0191SID%20%2F%20phid%3ACE8CF9B57D6C5C910000000000990080.4">Send us feedback</a><a id="jr-about-sw" data-path="/corehtml/pmc/jatsreader/ptpmc_3.22/" data-href="/corehtml/pmc/jatsreader/ptpmc_3.22/img/bookshelf/about.xml" href="">About PubReader</a></div></aside><aside id="jr-objectbox" class="thidden hidden"><div class="jr-objectbox-close wsprkl">✘</div><div class="jr-objectbox-inner cnt"><div class="jr-objectbox-drawer"></div></div></aside><nav id="jr-pm-left" class="hidden"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 40 800" preserveAspectRatio="none"><text font-stretch="ultra-condensed" x="800" y="-15" text-anchor="end" transform="rotate(90)" font-size="18" letter-spacing=".1em">Previous Page</text></svg></nav><nav id="jr-pm-right" class="hidden"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 40 800" preserveAspectRatio="none"><text font-stretch="ultra-condensed" x="800" y="-15" text-anchor="end" transform="rotate(90)" font-size="18" letter-spacing=".1em">Next Page</text></svg></nav><nav id="jr-fip" class="hidden"><nav id="jr-fip-term-p"><input type="search" placeholder="search this page" id="jr-fip-term" autocorrect="off" autocomplete="off" /><a id="jr-fip-mg" class="wsprkl btn" title="Find"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 550 600" preserveAspectRatio="none"><path fill="none" stroke="#000" stroke-width="36" stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-fip-done" class="wsprkl btn" title="Dismiss find">✘</a></nav><nav id="jr-fip-info-p"><a id="jr-fip-prev" class="wsprkl btn" title="Jump to previuos match">◀</a><button id="jr-fip-matches">no matches yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style"><div class="fm-sec bkr_bottom_sep"><div class="bkr_thumb"><a href="https://www.nice.org.uk" title="National Institute for Health and Care Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng234er13-lrg.png" alt="Cover of Evidence reviews for radiotherapy" /></a></div><div class="bkr_bib"><h1 id="_NBK595812_"><span itemprop="name">Evidence reviews for radiotherapy</span></h1><div class="subtitle">Spinal metastases and metastatic spinal cord compression</div><p><b>Evidence review M</b></p><p><i>NICE Guideline, No. 234</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2023 Sep</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-5323-3</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2023.</div></div><div class="bkr_clear"></div></div><div id="niceng234er13.s1"><h2 id="_niceng234er13_s1_">Radiotherapy</h2><div id="niceng234er13.s1.1"><h3>Review question</h3><p>How effective is radiotherapy, including both fractionated and unfractionated radiotherapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</p><div id="niceng234er13.s1.1.1"><h4>Introduction</h4><p>External beam radiotherapy is widely used for the treatment of painful spinal metastases. A variety of regimen and techniques have been used, and there is some uncertainty over which are the most appropriate. Radiotherapy regimens range from a single dose of 8Gy to fractionated regimens delivered in multiple doses. Different techniques have also been used: for example stereotactic radiotherapy delivers a precise focused dose compared to conventional external beam radiotherapy – but it is unclear whether this leads to improved outcomes.</p></div><div id="niceng234er13.s1.1.2"><h4>Summary of the protocol</h4><p>See <a class="figpopup" href="/books/NBK595812/table/niceng234er13.tab1/?report=objectonly" target="object" rid-figpopup="figniceng234er13tab1" rid-ob="figobniceng234er13tab1">Table 1</a> for a summary of the Population, Intervention, Comparison and Outcome (PICO) characteristics of this review.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng234er13tab1"><a href="/books/NBK595812/table/niceng234er13.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng234er13tab1" rid-ob="figobniceng234er13tab1"><img class="small-thumb" src="/books/NBK595812/table/niceng234er13.tab1/?report=thumb" src-large="/books/NBK595812/table/niceng234er13.tab1/?report=previmg" alt="Table 1. Summary of the protocol (PICO table)." /></a><div class="icnblk_cntnt"><h4 id="niceng234er13.tab1"><a href="/books/NBK595812/table/niceng234er13.tab1/?report=objectonly" target="object" rid-ob="figobniceng234er13tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Summary of the protocol (PICO table). </p></div></div><p>For further details see the review protocol in <a href="#niceng234er13.appa">appendix A</a>.</p></div><div id="niceng234er13.s1.1.3"><h4>Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>. Methods specific to this review question are described in the review protocol in <a href="#niceng234er13.appa">appendix A</a> and the <a href="/books/NBK595812/bin/NG234_Supp_1_Methods_pdf.pdf">methods</a> document (supplementary document 1).</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s conflicts of interest policy</a>.</p></div><div id="niceng234er13.s1.1.4"><h4>Effectiveness</h4><div id="niceng234er13.s1.1.4.1"><h5>Included studies</h5><p>Nineteen studies were included in this review reporting results from 13 randomised controlled trials (<a class="bibr" href="#niceng234er13.s1.ref1" rid="niceng234er13.s1.ref1">Hoskin 2019 [SCORAD-III trial]</a>, <a class="bibr" href="#niceng234er13.s1.ref2" rid="niceng234er13.s1.ref2">Howell 2013 [RTOG 97-14 trial]</a>, <a class="bibr" href="#niceng234er13.s1.ref3" rid="niceng234er13.s1.ref3">Lee 2018</a> [ICORG 05-03 trial], <a class="bibr" href="#niceng234er13.s1.ref4" rid="niceng234er13.s1.ref4">Majumder 2012</a>, <a class="bibr" href="#niceng234er13.s1.ref5" rid="niceng234er13.s1.ref5">Maranzano 2005</a>, <a class="bibr" href="#niceng234er13.s1.ref6" rid="niceng234er13.s1.ref6">Maranzano 2009</a>, <a class="bibr" href="#niceng234er13.s1.ref7" rid="niceng234er13.s1.ref7">Patchell 2005</a>, <a class="bibr" href="#niceng234er13.s1.ref8" rid="niceng234er13.s1.ref8">Rades 2016 [SCORE-2 trial]</a>, <a class="bibr" href="#niceng234er13.s1.ref9" rid="niceng234er13.s1.ref9">Rades 2018 [SCORE-2 trial]</a>, <a class="bibr" href="#niceng234er13.s1.ref10" rid="niceng234er13.s1.ref10">Rades 2019 [SCORE-2 trial]</a>, <a class="bibr" href="#niceng234er13.s1.ref11" rid="niceng234er13.s1.ref11">Roos 2005 [TROG 96-05 trial]</a>, <a class="bibr" href="#niceng234er13.s1.ref12" rid="niceng234er13.s1.ref12">Sahgal 2021</a>, <a class="bibr" href="#niceng234er13.s1.ref13" rid="niceng234er13.s1.ref13">Sprave 2018 – a</a>, <a class="bibr" href="#niceng234er13.s1.ref14" rid="niceng234er13.s1.ref14">b</a>, <a class="bibr" href="#niceng234er13.s1.ref15" rid="niceng234er13.s1.ref15">c [IRON-1 trial]</a>, <a class="bibr" href="#niceng234er13.s1.ref16" rid="niceng234er13.s1.ref16">Sprave 2018d</a>, <a class="bibr" href="#niceng234er13.s1.ref17" rid="niceng234er13.s1.ref17">e</a>, <a class="bibr" href="#niceng234er13.s1.ref18" rid="niceng234er13.s1.ref18">f [NCT- 02358720]</a>, <a class="bibr" href="#niceng234er13.s1.ref19" rid="niceng234er13.s1.ref19">Steenland 1999 [Dutch bone metastasis trial]</a>).</p><p>The included studies are summarised in <a class="figpopup" href="/books/NBK595812/table/niceng234er13.tab2/?report=objectonly" target="object" rid-figpopup="figniceng234er13tab2" rid-ob="figobniceng234er13tab2">Table 2</a>.</p><p>Four randomised controlled trials (<a class="bibr" href="#niceng234er13.s1.ref2" rid="niceng234er13.s1.ref2">Howell 2013 [RTOG 97-14]</a>, <a class="bibr" href="#niceng234er13.s1.ref4" rid="niceng234er13.s1.ref4">Majumder 2012</a>, <a class="bibr" href="#niceng234er13.s1.ref11" rid="niceng234er13.s1.ref11">Roos 2005 [TROG 96-05]</a>, <a class="bibr" href="#niceng234er13.s1.ref19" rid="niceng234er13.s1.ref19">Steenland 1999 [Dutch Bone Metastasis trial]</a>) compared single fraction radio-therapy to multiple fraction radiotherapy in patients with spinal metastases (without evidence of cord compression).</p><p>Three randomised controlled trials (<a class="bibr" href="#niceng234er13.s1.ref1" rid="niceng234er13.s1.ref1">Hoskin 2019 [SCORAD-III trial]</a>), <a class="bibr" href="#niceng234er13.s1.ref3" rid="niceng234er13.s1.ref3">Lee 2018 [ICORG 05-03 trial]</a>, <a class="bibr" href="#niceng234er13.s1.ref6" rid="niceng234er13.s1.ref6">Maranzano 2009</a>), compared single fraction radiotherapy to multiple fraction or split-course radiotherapy in patients <i>with</i> metastatic spinal cord compression.</p><p>One randomised controlled trial (<a class="bibr" href="#niceng234er13.s1.ref13" rid="niceng234er13.s1.ref13">Sprave 2018a</a>, <a class="bibr" href="#niceng234er13.s1.ref14" rid="niceng234er13.s1.ref14">b</a>, <a class="bibr" href="#niceng234er13.s1.ref15" rid="niceng234er13.s1.ref15">c [IRON-1 trial]</a>) compared image guided intensity modulated radiotherapy (IMRT) to conventional radiotherapy (CRT) in patients with spinal metastases (without evidence of cord compression).</p><p>Two randomised controlled trials (<a class="bibr" href="#niceng234er13.s1.ref12" rid="niceng234er13.s1.ref12">Sahgal 2021</a>, <a class="bibr" href="#niceng234er13.s1.ref16" rid="niceng234er13.s1.ref16">Sprave 2018d</a>, <a class="bibr" href="#niceng234er13.s1.ref17" rid="niceng234er13.s1.ref17">e</a>, <a class="bibr" href="#niceng234er13.s1.ref18" rid="niceng234er13.s1.ref18">f [NCT- 02358720]</a>) compared stereotactic ablative body radiotherapy (SABR) to CRT in patients with spinal metastases (without evidence of cord compression).</p><p>Two randomised controlled trials compared different regimens of radiotherapy (<a class="bibr" href="#niceng234er13.s1.ref5" rid="niceng234er13.s1.ref5">Maranzano 2005</a>, <a class="bibr" href="#niceng234er13.s1.ref8" rid="niceng234er13.s1.ref8">Rades 2016 [SCORE-2 trial]</a>, <a class="bibr" href="#niceng234er13.s1.ref9" rid="niceng234er13.s1.ref9">Rades 2018</a>, <a class="bibr" href="#niceng234er13.s1.ref10" rid="niceng234er13.s1.ref10">Rades 2019 [SCORE-2 trial]</a>) in patients <i>with</i> metastatic spinal cord compression; and 1 randomised controlled trial compared surgery + radiotherapy to radiotherapy alone (<a class="bibr" href="#niceng234er13.s1.ref7" rid="niceng234er13.s1.ref7">Patchell 2005</a>) in patients with metastatic spinal cord compression.</p><p>See the literature search strategy in <a href="#niceng234er13.appb">appendix B</a> and study selection flow chart in <a href="#niceng234er13.appc">appendix C</a>.</p></div><div id="niceng234er13.s1.1.4.2"><h5>Excluded studies</h5><p>Studies not included in this review are listed, and reasons for their exclusion are provided in <a href="#niceng234er13.appk">appendix K</a>.</p></div></div><div id="niceng234er13.s1.1.5"><h4>Summary of included studies</h4><p>Summaries of the studies that were included in this review are presented in <a class="figpopup" href="/books/NBK595812/table/niceng234er13.tab2/?report=objectonly" target="object" rid-figpopup="figniceng234er13tab2" rid-ob="figobniceng234er13tab2">Table 2</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng234er13tab2"><a href="/books/NBK595812/table/niceng234er13.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng234er13tab2" rid-ob="figobniceng234er13tab2"><img class="small-thumb" src="/books/NBK595812/table/niceng234er13.tab2/?report=thumb" src-large="/books/NBK595812/table/niceng234er13.tab2/?report=previmg" alt="Table 2. Summary of included studies." /></a><div class="icnblk_cntnt"><h4 id="niceng234er13.tab2"><a href="/books/NBK595812/table/niceng234er13.tab2/?report=objectonly" target="object" rid-ob="figobniceng234er13tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of included studies. </p></div></div><p>See the full evidence tables in <a href="#niceng234er13.appd">appendix D</a> and the forest plots in <a href="#niceng234er13.appe">appendix E</a>.</p></div><div id="niceng234er13.s1.1.6"><h4>Economic evidence</h4><div id="niceng234er13.s1.1.6.1"><h5>Included studies</h5><p>One economic study was identified which was relevant to this review question. (<a class="bibr" href="#niceng234er13.s1.ref20" rid="niceng234er13.s1.ref20">Turner 2018</a>) The study compared surgery and radiotherapy to radiotherapy alone.</p><p>A single <a href="/books/NBK595812/bin/NG234_Supp_2_Health_economics_pdf.pdf">economic</a> search was undertaken for all topics included in the scope of this guideline. See supplement 2 for details.</p></div><div id="niceng234er13.s1.1.6.2"><h5>Excluded studies</h5><p><a href="/books/NBK595812/bin/NG234_Supp_2_Health_economics_pdf.pdf">Economic</a> studies not included in this review are listed, and reasons for their exclusion are provided in supplement 2.</p></div></div><div id="niceng234er13.s1.1.7"><h4>Summary of the evidence</h4><div id="niceng234er13.s1.1.7.1"><h5>People with painful spinal bone metastases (but no evidence of spinal cord compression)</h5><div id="niceng234er13.s1.1.7.1.1"><h5>Single fraction verses multiple fraction radiotherapy</h5><p>There was very low to low quality evidence of no important difference between single fraction radiotherapy and multiple fractions in terms of pain reduction, spinal stability and overall survival. There was very low quality evidence of an important benefit with single fraction radio-therapy which had fewer treatment related adverse events than multiple fractions.</p></div><div id="niceng234er13.s1.1.7.1.2"><h5>IMRT verses 3D-CRT</h5><p>There was no evidence of an importance difference between IMRT and 3D-CRT in terms of quality of life, pain response, treatment related morbidity or overall survival in one small trial. This evidence was very low quality.</p></div><div id="niceng234er13.s1.1.7.1.3"><h5>SABR verses conventional radiotherapy</h5><p>There was an important benefit with SABR when compared to conventional RT (EBRT or 3D-CRT) in reducing pain. There was no evidence of important differences in quality of life, treatment related morbidity or overall survival. This evidence was all low quality.</p></div></div><div id="niceng234er13.s1.1.7.2"><h5>People with metastatic spinal cord compression</h5><div id="niceng234er13.s1.1.7.2.1"><h5>Single fraction verses multiple fraction radiotherapy</h5><p>There was moderate to high quality evidence of no important difference between single fraction radiotherapy and multiple fractions in terms of neurological and functional status, quality of life, pain, overall survival and treatment toxicity.</p></div><div id="niceng234er13.s1.1.7.2.2"><h5>Short course verses split or long course radiotherapy</h5><p>There was low to high quality evidence of no important difference between short course radiotherapy and split or long course radiotherapy in terms of neurological and functional status, pain response and treatment related morbidity.</p></div><div id="niceng234er13.s1.1.7.2.3"><h5>Surgery plus radiotherapy verses radiotherapy alone</h5><p>There was moderate to high quality evidence of an important benefit for surgery + radiotherapy over radiotherapy alone for neurological and functional status (ability to walk, continence and muscle strength).</p><p>See <a href="#niceng234er13.appf">appendix F</a> for full GRADE tables.</p></div></div></div><div id="niceng234er13.s1.1.8"><h4>Summary of included economic evidence</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng234er13tab3"><a href="/books/NBK595812/table/niceng234er13.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figniceng234er13tab3" rid-ob="figobniceng234er13tab3"><img class="small-thumb" src="/books/NBK595812/table/niceng234er13.tab3/?report=thumb" src-large="/books/NBK595812/table/niceng234er13.tab3/?report=previmg" alt="Table 3. Economic evidence profile of an economic evaluation of the addition of radiotherapy for people undergoing surgery for metastatic spinal cord compression." /></a><div class="icnblk_cntnt"><h4 id="niceng234er13.tab3"><a href="/books/NBK595812/table/niceng234er13.tab3/?report=objectonly" target="object" rid-ob="figobniceng234er13tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Economic evidence profile of an economic evaluation of the addition of radiotherapy for people undergoing surgery for metastatic spinal cord compression. </p></div></div></div><div id="niceng234er13.s1.1.9"><h4>Economic model</h4><p>No economic modelling was undertaken for this review because the committee agreed that other topics were higher priorities for economic evaluation.</p></div><div id="niceng234er13.s1.1.10"><h4>Evidence Statement</h4><p><a class="bibr" href="#niceng234er13.s1.ref20" rid="niceng234er13.s1.ref20">Turner 2018</a> was a cost utility analysis which reported outcomes in terms of cost per QALY gained for surgery and radiotherapy versus radiotherapy alone in people with symptomatic spinal metastases.</p><p>The study found surgery and radiotherapy to be cost saving and health improving compared to radiotherapy alone. This was robust to deterministic sensitivity analysis. The study was deemed to be directly applicable to the review question with potentially serious methodological limitations.</p></div><div id="niceng234er13.s1.1.11"><h4>The committee’s discussion and interpretation of the evidence</h4><div id="niceng234er13.s1.1.11.1"><h5>The outcomes that matter most</h5><p>Health related quality of life, pain and neurological and functional status were chosen as critical outcomes because untreated malignant spinal disease can impact on quality of life due to severe pain and impaired neurological and functional status. Overall survival was also a critical outcome because radiotherapy can potentially prolong life.</p><p>The committee agreed that treatment related morbidity is an important outcome, due to side effects of radiotherapy, and is an important consideration when choosing radiotherapy dose and fractionation. Spinal stability was also an important outcome, because different radio-therapy doses and fractionations may have differing impact on re-ossification rates of unstable spinal bone metastases. Fitness for subsequent anti-cancer therapy was an important outcome because morbidity due to radiotherapy could delay further anti-cancer therapy until the person recovers fitness.</p></div><div id="niceng234er13.s1.1.11.2"><h5>The quality of the evidence</h5><p>The quality of the evidence for outcomes was assessed with GRADE and ranged from very low to high. The main issues that lowered the quality of the evidence were risk of bias as per Cochrane RoB 2 and imprecision of the effect estimates. In one case evidence quality was downgraded for indirectness because the study included some people with non-spinal bone metastases.</p><p>The committee considered the quality of evidence was sufficient to make recommendations on fractionation and on SABR for painful spinal metastases. They used their clinical experience to make recommendations where there was a lack of evidence on the timing of radio-therapy, radiotherapy for people with asymptomatic spinal metastases and the use of SABR for MSCC.</p></div><div id="niceng234er13.s1.1.11.3"><h5>Benefits and harms</h5></div><div id="niceng234er13.s1.1.11.4"><h5>Radiotherapy and fertility</h5><p>The committee agreed that the impact on future fertility of both the cancer and the radiotherapy treatment should be discussed with the person and, if appropriate (for example, depending on age and preferences), a referral should be made to a fertility. The committee discussed that treatment of MSCC is usually urgent and fertility treatment can take time to organise and undertake in practice and that it is therefore important to bear in mind that MSCC treatment should not be delayed awaiting further discussions with a fertility specialist. They also acknowledged that radiotherapy fields for MSCC would usually not affect the gonads so, urgent radiotherapy treatment might not impact as much on fertility as radiotherapy does for other cancers which is another reason why urgent treatment should not be delayed.</p></div><div id="niceng234er13.s1.1.11.5"><h5>Radiotherapy to treat painful spinal metastases or DMI of the spine and prevent MSCC</h5><p>Evidence supported the recommendation for single fraction radiotherapy in people with painful spinal metastases (without MSCC). They acknowledged that there are people who can have their pain controlled in other ways, too, but this is covered by Evidence Review I. Single fraction radiotherapy appeared as effective as multiple fractions in terms of reducing pain but with fewer adverse effects. Although the evidence was very low quality, the committee discussed that a strong recommendation was supported because single fractionation would likely be more acceptable to patients with fewer visits and transfers required to complete the treatment. There was limited evidence from 2 small RCTs that stereotactic ablative body radio-therapy (SABR) is more effective than conventional radiotherapy in reducing pain for people with spinal metastases without MSCC. Although the evidence was very low quality the committee agreed that the ability of SABR to deliver a precise dose while sparing damage to healthy tissue supported their recommendation. The committee agreed that this could be an option for a subgroup of people who have a good overall prognosis because they can tolerate this radiotherapy and it would not be too risky. They also discussed that those with limited metastatic disease (based on expertise they thought currently up to 3 discrete metastases would be considered standard for oligometastases in accordance with <a href="https://urlsand.esvalabs.com/?u=https%3A%2F%2Fwww.england.nhs.uk%2Fpublication%2Fstereotactic-ablative-radiotherapy-sabr-for-patients-with-metachronous-extracranial-oligometastatic-cancer-all-ages%2F&e=9f250c40&h=f70be268&f=y&p=n" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NHS commissioning of stereotactic ablative body radiotherapy</a>) could benefit from this. They agreed that this number would balance the potential that all cancer sites could be controlled with an acceptable level of toxicity.</p><p>Although there was a lack of evidence about the impact of radiotherapy on stem cell harvest in people with haematological cancers, the committee agreed that in their experience it could lower the chance of a successful procedure. For this reason they recommended a discussion with the relevant haematology MDT whenever this was being considered to allow for careful consideration of the risks and benefits for each individual.</p></div><div id="niceng234er13.s1.1.11.6"><h5>Radiotherapy to treat MSCC</h5><p>Although there was no evidence on the timing of radiotherapy for people with MSCC, the committee agreed that MSCC can be an oncologic emergency and rapid access to radiotherapy would be needed in some cases to prevent neurological impairment (as soon as possible and within 24 hours). The committee discussed that in patients with MSCC who are not candidates for surgery, radiotherapy may help prevent further neurological damage and alleviate pain. In this situation radiotherapy should be given urgently – unless the person already has paraplegia or tetraplegia for 2 weeks or longer and their pain is controlled or their overall prognosis is poor. In these cases, the benefits of radiotherapy are unlikely to outweigh the harms.</p><p>There was evidence that single fractionation was as effective as multiple fractions for people with MSCC, but with the benefit of increased patient convenience and reduced costs. The committee agreed that a strong recommendation was appropriate based on the evidence and because this would lead to less time spent in multiple hospital visits which can be particularly important in a patient group with reduced life expectancy. This would also use fewer resources in relation to appointments and staff time.</p><p>The committee agreed, based on their experience, that it can be technically difficult to treat multilevel disease in a single dose and that radiologists avoid large single dose treatment fields which cover a large proportion of the spinal cord due to toxicity. For these reasons in some cases multiple fraction radiotherapy would be more appropriate.</p><p>The committee agreed to make a research recommendation stereotactic ablative body radiotherapy for the treatment of MSCC, given a lack of evidence about its use in this indication.</p></div><div id="niceng234er13.s1.1.11.7"><h5>Radiotherapy for asymptomatic spinal metastases</h5><p>There was a lack of evidence about the use of radiotherapy in people with asymptomatic spinal metastases. The committee agreed that benefits of radiotherapy were less clear cut in this population whereas the harms of radiotherapy are known. They recommended radiotherapy only in limited circumstances: for those with limited metastatic disease (where radiotherapy could be used to control disease), if there are radiological signs of impending cord compression by an epidural or intradural tumour (where presumably radiotherapy may prevent progression to symptomatic MSCC) and for those in a randomised trial.</p></div><div id="niceng234er13.s1.1.11.8"><h5>Postoperative radiotherapy</h5><p>There was evidence showing that radiotherapy and surgery had an important benefit in relation to neurological and functional status over radiotherapy alone. The committee noted also that this is now routine practice in most services and is suitable for most people with MSCC post surgery. To standardise this practice and based on the evidence they recommended that postoperative radiotherapy should be offered.</p></div><div id="niceng234er13.s1.1.11.9"><h5>Further radiotherapy</h5><p>The committee also discussed retreatment with radiotherapy in people who had previously had radiotherapy. No evidence was identified so the committee, based on experience, decided to recommend this treatment option in some cases but also to highlight some of the factors linked to treatment toxicity (dose, timing and volume of treatment field) that should be taken into account when making decisions about whether or not to offer further radiotherapy treatment.</p></div><div id="niceng234er13.s1.1.11.10"><h5>Providing urgent radiotherapy services</h5><p>The committee discussed that their recommendation regarding radiotherapy within 24 hours would require some configuration of services that would help enable this to happen. Based on experience they therefore recommended that MSCC services need to ensure that radio-therapy and simulator facilities are available for urgent (within 24 hours) daytime sessions, 7 days a week. This would enable treatment to be given within this timeframe.</p></div><div id="niceng234er13.s1.1.11.11"><h5>Cost effectiveness and resource use</h5><p>The economic evidence showed that giving post-operative radiotherapy to people who have undergone surgery will be cost saving and health improving compared to radiotherapy alone. These savings and health improvements are largely being driven through people being ambulant for longer periods of time, improving quality of life and reducing costs to community services which are involved with non-ambulant people.</p><p>Stereotactic ablative body radiotherapy (SABR) is not widely used for painful spinal metastases in the NHS and would represent a change in practice. The technology is already available in the NHS for other cancers and all cancer centres will already have access to this technology. These recommendations will increase the use of stereotactic ablative body radiotherapy but this is similar in cost to alternative radiotherapy and the committee agreed this will not lead to a significant resource impact. There may be an initial cost of setting up pathways for people with painful spinal metastases to access SABR, as these are not currently established, but this will be a one-off cost and would not lead to significant resource impact. There was also evidence that SABR will reduce pain leading to reduced use of analgesics and other treatments for pain, decreasing costs and increasing quality of life. The committee therefore concluded that SABR was likely to be cost neutral or potentially cost saving once the initial set-up costs had been incurred.</p></div></div><div id="niceng234er13.s1.1.12"><h4>Recommendations supported by this evidence review</h4><p>This evidence review supports recommendations 1.1.21, 1.10.1 to 1.10.10 and research recommendation 1 on the effectiveness of stereotactic ablative body radiotherapy in the treatment of MSCC, in the guideline.</p></div></div><div id="niceng234er13.s1.rl.r1"><h3>References – included studies</h3><ul class="simple-list"><div id="niceng234er13.s1.rl.r1.1"><h4>Effectiveness</h4><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref1"><p id="p-268">
|
|
<strong>Hoskin 2019 [SCORAD-III trial]</strong>
|
|
</p>Hoskin
|
|
P, Hopkins
|
|
K, Misra
|
|
V, et al. Effect of Single-Fraction vs Multifraction Radiotherapy on Ambulatory Status Among Patients With Spinal Canal Compression From Metastatic Cancer: the SCORAD Randomized Clinical Trial. JAMA
|
|
322, 2084–2094, 2019 [<a href="/pmc/articles/PMC6902166/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6902166</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31794625" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31794625</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref2"><p id="p-269">
|
|
<strong>Howell 2013 [RTOG 97-14 trial]</strong>
|
|
</p>Howell
|
|
D, James
|
|
J, Hartsell
|
|
W, et al. Single-fraction radiotherapy versus multifraction radio-therapy for palliation of painful vertebral bone metastases - Equivalent efficacy, less toxicity, more convenient: A subset analysis of Radiation Therapy Oncology Group trial 97-14. Cancer
|
|
119, 888–896, 2013 [<a href="/pmc/articles/PMC5746185/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5746185</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23165743" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23165743</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref3"><p id="p-270">
|
|
<strong>Lee 2018 [ICORG 05-03 trial]</strong>
|
|
</p>Lee
|
|
K, Dunne
|
|
M, Small
|
|
C, et al. (ICORG 05-03): prospective randomized non-inferiority phase III trial comparing two radiation schedules in malignant spinal cord compression (not proceeding with surgical decompression); the quality of life analysis. Acta Oncologica, 1–8, 2018 [<a href="https://pubmed.ncbi.nlm.nih.gov/29419331" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29419331</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref4"><p id="p-271">
|
|
<strong>Majumder 2012</strong>
|
|
</p>Majumder
|
|
D, Chatterjee
|
|
D, Bandyopadhyay
|
|
A, et al. Single Fraction versus Multiple Fraction Radiotherapy for Palliation of Painful Vertebral Bone Metastases: A Prospective Study. Indian Journal of Palliative Care, 18, 202–6, 2012 [<a href="/pmc/articles/PMC3573475/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3573475</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23440009" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23440009</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref5"><p id="p-272">
|
|
<strong>Maranzano 2005</strong>
|
|
</p>Maranzano
|
|
E, Bellavita
|
|
R, Rossi
|
|
R, et al. Short-course versus split-course radiotherapy in metastatic spinal cord compression: results of a phase III, randomized, multicenter trial. Journal of Clinical Oncology
|
|
23: 3358–65, 2005 [<a href="https://pubmed.ncbi.nlm.nih.gov/15738534" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15738534</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref6"><p id="p-273">
|
|
<strong>Maranzano 2009</strong>
|
|
</p>Maranzano
|
|
E, Trippa
|
|
F, Casale
|
|
M, et al. 8Gy single-dose radiotherapy is effective in metastatic spinal cord compression: results of a phase III randomized multicentre Italian trial. Radiotherapy and Oncology
|
|
93, 174–9, 2009 [<a href="https://pubmed.ncbi.nlm.nih.gov/19520448" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19520448</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref7"><p id="p-274">
|
|
<strong>Patchell 2005</strong>
|
|
</p>Patchell
|
|
R, Tibbs
|
|
P
|
|
Regine
|
|
W, et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet
|
|
366, 643–8, 2005 [<a href="https://pubmed.ncbi.nlm.nih.gov/16112300" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16112300</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref8"><p id="p-275">
|
|
<strong>Rades 2016 [SCORE-2 trial]</strong>
|
|
</p>Rades
|
|
D, Šegedin
|
|
B, Conde-Moreno
|
|
A, et al, Radiotherapy With 4 Gy × 5 Versus 3 Gy × 10 for Metastatic Epidural Spinal Cord Compression: final results of the SCORE-2 Trial (ARO 2009/01). Journal of Clinical Oncology
|
|
34, 597–602, 2016 [<a href="https://pubmed.ncbi.nlm.nih.gov/26729431" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26729431</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref9"><p id="p-276">
|
|
<strong>Rades 2018 [SCORE-2 trial]</strong>
|
|
</p>Rades
|
|
D, Conde-Moreno
|
|
A, Cacicedo
|
|
J
|
|
et al. Comparison of Two Radiotherapy Regimens for Metastatic Spinal Cord Compression: subgroup Analyses from a Randomized Trial. Anti-cancer Research
|
|
38, 1009–1015, 2018 [<a href="https://pubmed.ncbi.nlm.nih.gov/29374734" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29374734</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref10"><p id="p-277">
|
|
<strong>Rades 2019 [SCORE-2 trial]</strong>
|
|
</p>Rades
|
|
D, Segedin
|
|
B, Conde-Moreno
|
|
A, et al. Patient-Reported Outcomes-Secondary Analysis of the SCORE-2 Trial Comparing 4 Gy x 5 to 3 Gy x 10 for Metastatic Epidural Spinal Cord Compression. International Journal of Radiation Oncology, Biology, Physics, 105, 760–764, 2019 [<a href="https://pubmed.ncbi.nlm.nih.gov/31415797" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31415797</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref11"><p id="p-278">
|
|
<strong>Roos 2005 [TROG 96-05 trial]</strong>
|
|
</p>Roos
|
|
D, Turner
|
|
S, O’Brien, P, et al. Randomized trial of 8 Gy in 1 versus 20 Gy in 5 fractions of radiotherapy for neuropathic pain due to bone metastases (Trans-Tasman Radiation Oncology Group, TROG 96.05). Radiotherapy and Oncology
|
|
75, 54–63, 2005 [<a href="https://pubmed.ncbi.nlm.nih.gov/15878101" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15878101</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref12"><p id="p-279">
|
|
<strong>Sahgal 2021</strong>
|
|
</p>Sahgal
|
|
A, Myrehaug
|
|
S, Siva
|
|
S, et al. Stereotactic body radiotherapy versus conventional external beam radiotherapy in patients with painful spinal metastases: an open-label, multicentre, randomised, controlled, phase 2/3 trial. Lancet Oncology
|
|
22, 1023–1033, 2021 [<a href="https://pubmed.ncbi.nlm.nih.gov/34126044" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34126044</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref13"><p id="p-280">
|
|
<strong>Sprave 2018a [IRON-1 trial]</strong>
|
|
</p>Sprave
|
|
T, Verma
|
|
V, Förster
|
|
R
|
|
et al. Radiation-induced acute toxicities after image-guided intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy for patients with spinal metastases (IRON-1 trial): first results of a randomized controlled trial. Strahlen-therapie und Onkologie
|
|
194, 911–920, 2018 [<a href="https://pubmed.ncbi.nlm.nih.gov/29978307" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29978307</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref14"><p id="p-281">
|
|
<strong>Sprave 2018b [IRON-1 trial]</strong>
|
|
</p>Sprave
|
|
T, Verma
|
|
V, Förster
|
|
R
|
|
et al. Quality of Life and Radiation-induced Late Toxicity Following Intensity-modulated Versus Three-dimensional Conformal Radiotherapy for Patients with Spinal Bone Metastases: results of a Randomized Trial. Anticancer Research
|
|
38, 4953–4960, 2018 [<a href="https://pubmed.ncbi.nlm.nih.gov/30061275" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30061275</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref15"><p id="p-282">
|
|
<strong>Sprave 2018c [IRON-1 trial]</strong>
|
|
</p>Sprave
|
|
T, Verma
|
|
V, Förster
|
|
R, et al. Bone density and pain response following intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy for vertebral metastases - secondary results of a randomized trial. Radiation Oncology, 13, 212, 2018 [<a href="/pmc/articles/PMC6208115/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6208115</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30376859" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30376859</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref16"><p id="p-283">
|
|
<strong>Sprave 2018d [NCT - 02358720]</strong>
|
|
</p>Sprave
|
|
T, Verma
|
|
V, Forster
|
|
R, et al, Quality of Life Following Stereotactic Body Radiotherapy Versus Three-Dimensional Conformal Radiotherapy for Vertebral Metastases: Secondary Analysis of an Exploratory Phase II Randomized Trial. Anticancer Research
|
|
38, 4961–4968, 2018 [<a href="https://pubmed.ncbi.nlm.nih.gov/30061276" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30061276</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref17"><p id="p-284">
|
|
<strong>Sprave 2018e [NCT - 02358720]</strong>
|
|
</p>Sprave
|
|
T, Verma
|
|
V, Forster
|
|
R, et al, Randomized phase II trial evaluating pain response in patients with spinal metastases following stereotactic body radiotherapy versus three-dimensional conformal radiotherapy. Radiotherapy and Oncology
|
|
128, 274–282, 2018 [<a href="https://pubmed.ncbi.nlm.nih.gov/29843899" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29843899</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref18"><p id="p-285">
|
|
<strong>Sprave 2018f [NCT - 02358720]</strong>
|
|
</p>Sprave
|
|
T, Verma
|
|
V, Forster
|
|
R, et al, Local response and pathologic fractures following stereotactic body radiotherapy versus three-dimensional conformal radiotherapy for spinal metastases - a randomized controlled trial. BMC Cancer
|
|
18, 859, 2018 [<a href="/pmc/articles/PMC6119304/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6119304</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30170568" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30170568</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref19"><p id="p-286">
|
|
<strong>Steenland 1999 [Dutch Bone Metastasis trial]</strong>
|
|
</p>Steenland
|
|
E, Leer
|
|
J, van Houwelingen
|
|
H, et al. The effect of a single fraction compared to multiple fractions on painful bone metastases: a global analysis of the Dutch Bone Metastasis Study. Radiotherapy and Oncology, 52, 101–109, 1999 [<a href="https://pubmed.ncbi.nlm.nih.gov/10577695" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10577695</span></a>]</div></p></li></ul></div><div id="niceng234er13.s1.rl.r1.2"><h4>Economic</h4><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng234er13.s1.ref20"><p id="p-287">
|
|
<strong>Turner 2018</strong>
|
|
</p>Turner
|
|
I, Kennedy
|
|
J, Morris
|
|
S, et al. Surgery and radiotherapy for symptomatic spinal metastases is more cost effective than radiotherapy alone: a cost utility analysis in a UK Spinal Center. World Neurosurgery, 109, e389–e397, 2018. [<a href="https://pubmed.ncbi.nlm.nih.gov/28987846" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28987846</span></a>]</div></p></li></ul></div></ul></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng234er13.appa"><h3>Appendix A. Review protocols</h3><p id="niceng234er13.appa.et1"><a href="/books/NBK595812/bin/niceng234er13-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Review protocol for review question: How effective is radiotherapy, including both fractionated and unfractionated radio-therapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</a><span class="small"> (PDF, 196K)</span></p></div><div id="niceng234er13.appb"><h3>Appendix B. Search strategy (clinical/economic)</h3><p id="niceng234er13.appb.et1"><a href="/books/NBK595812/bin/niceng234er13-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Literature search strategies for review question: How effective is radiotherapy, including both fractionated and unfractionated radiotherapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</a><span class="small"> (PDF, 109K)</span></p></div><div id="niceng234er13.appc"><h3>Appendix C. Effectiveness evidence study selection</h3><p id="niceng234er13.appc.et1"><a href="/books/NBK595812/bin/niceng234er13-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Study selection for: How effective is radiotherapy, including both fractionated and unfractionated radiotherapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</a><span class="small"> (PDF, 100K)</span></p></div><div id="niceng234er13.appd"><h3>Appendix D. Evidence tables</h3><p id="niceng234er13.appd.et1"><a href="/books/NBK595812/bin/niceng234er13-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Evidence tables for review question: How effective is radiotherapy, including both fractionated and unfractionated radiotherapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</a><span class="small"> (PDF, 554K)</span></p></div><div id="niceng234er13.appe"><h3>Appendix E. Forest plots</h3><p id="niceng234er13.appe.et1"><a href="/books/NBK595812/bin/niceng234er13-appe-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Forest plots for review question: How effective is radiotherapy, including both fractionated and unfractionated radiotherapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</a><span class="small"> (PDF, 285K)</span></p></div><div id="niceng234er13.appf"><h3>Appendix F. GRADE tables</h3><p id="niceng234er13.appf.et1"><a href="/books/NBK595812/bin/niceng234er13-appf-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">GRADE tables for review question: How effective is radiotherapy, including both fractionated and unfractionated radiotherapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</a><span class="small"> (PDF, 370K)</span></p></div><div id="niceng234er13.appg"><h3>Appendix G. Economic evidence study selection</h3><div id="niceng234er13.appg.s1"><h4>Study selection for: How effective is radiotherapy, including both fractionated and unfractionated radiotherapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</h4><p>A global search of economic evidence was undertaken for all review questions in this guideline. See Supplement 2 for further information</p></div></div><div id="niceng234er13.apph"><h3>Appendix H. Economic evidence tables</h3><p id="niceng234er13.apph.et1"><a href="/books/NBK595812/bin/niceng234er13-apph-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Economic evidence tables for review question: How effective is radiotherapy, including both fractionated and unfractionated radiotherapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</a><span class="small"> (PDF, 140K)</span></p></div><div id="niceng234er13.appi"><h3>Appendix I. Economic model</h3><div id="niceng234er13.appi.s1"><h4>Economic model for review question: How effective is radiotherapy, including both fractionated and unfractionated radiotherapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</h4><p>No economic analysis was conducted for this review question.</p></div></div><div id="niceng234er13.appj"><h3>Appendix J. Excluded studies</h3><div id="niceng234er13.appj.s1"><h4>Excluded studies for review question: How effective is radiotherapy, including both fractionated and unfractionated radiotherapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</h4><div id="niceng234er13.appj.s1.1"><h5>Excluded effectiveness studies</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng234er13appjtab1"><a href="/books/NBK595812/table/niceng234er13.appj.tab1/?report=objectonly" target="object" title="Table 14" class="img_link icnblk_img figpopup" rid-figpopup="figniceng234er13appjtab1" rid-ob="figobniceng234er13appjtab1"><img class="small-thumb" src="/books/NBK595812/table/niceng234er13.appj.tab1/?report=thumb" src-large="/books/NBK595812/table/niceng234er13.appj.tab1/?report=previmg" alt="Table 14. Excluded studies and reasons for their exclusion." /></a><div class="icnblk_cntnt"><h4 id="niceng234er13.appj.tab1"><a href="/books/NBK595812/table/niceng234er13.appj.tab1/?report=objectonly" target="object" rid-ob="figobniceng234er13appjtab1">Table 14</a></h4><p class="float-caption no_bottom_margin">Excluded studies and reasons for their exclusion. </p></div></div></div><div id="niceng234er13.appj.s1.2"><h5>Excluded economic studies</h5><p>A global search of economic evidence was undertaken for all review questions in this guideline. See Supplement 2 for further information</p></div></div></div><div id="niceng234er13.appk"><h3>Appendix K. Research recommendations – full details</h3><p id="niceng234er13.appk.et1"><a href="/books/NBK595812/bin/niceng234er13-appk-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Research recommendations for review question: How effective is radiotherapy, including both fractionated and unfractionated radiotherapy, for the management of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?</a><span class="small"> (PDF, 157K)</span></p></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>These evidence reviews were developed by NICE</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="https://www.gov.wales/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2023.</div><div class="small"><span class="label">Bookshelf ID: NBK595812</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/37824688" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">37824688</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng234er13tab1"><div id="niceng234er13.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of the protocol (PICO table)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595812/table/niceng234er13.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng234er13.tab1_lrgtbl__"><table class="no_bottom_margin"><tbody><tr><th id="hd_b_niceng234er13.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_niceng234er13.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults with:
|
|
<ul><li class="half_rhythm"><div>metastatic spinal disease</div></li><li class="half_rhythm"><div>direct malignant infiltration of the spine</div></li></ul>
|
|
Adults with confirmed spinal cord or nerve root compression because of:
|
|
<ul><li class="half_rhythm"><div>metastatic spinal disease</div></li><li class="half_rhythm"><div>direct malignant infiltration.</div></li></ul>
|
|
</td></tr><tr><th id="hd_b_niceng234er13.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_niceng234er13.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Radiotherapy (RT):
|
|
<ul><li class="half_rhythm"><div>Unfractionated RT (including stereotactic techniques)</div></li><li class="half_rhythm"><div>Fractionated RT</div></li></ul>
|
|
</td></tr><tr><th id="hd_b_niceng234er13.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_niceng234er13.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>No RT (with or without surgery)</div></li><li class="half_rhythm"><div>Repeated single site treatments versus one multi-site treatment</div></li><li class="half_rhythm"><div>Surgery with post-op RT versus RT alone</div></li><li class="half_rhythm"><div>Different fractionation</div></li><li class="half_rhythm"><div>Different dosage</div></li><li class="half_rhythm"><div>Different RT technique</div></li></ul>
|
|
</td></tr><tr><th id="hd_b_niceng234er13.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</th><td headers="hd_b_niceng234er13.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
|
|
<ul><li class="half_rhythm"><div>Health related quality of life</div></li><li class="half_rhythm"><div>Neurological and functional status including:
|
|
<ul class="circle"><li class="half_rhythm"><div>Bowel & bladder function</div></li><li class="half_rhythm"><div>Mobility or ambulatory status</div></li></ul></div></li><li class="half_rhythm"><div>Overall survival</div></li><li class="half_rhythm"><div>Pain</div></li></ul>
|
|
<b>Important</b>
|
|
<ul><li class="half_rhythm"><div>Treatment related morbidity</div></li><li class="half_rhythm"><div>Spinal stability (especially in those who did not have surgery)</div></li><li class="half_rhythm"><div>Fitness for subsequent anti-cancer therapy</div></li></ul>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">RT: radiotherapy.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng234er13tab2"><div id="niceng234er13.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of included studies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595812/table/niceng234er13.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng234er13.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study/trial</th><th id="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><th id="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><th id="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng234er13.s1.ref1" rid="niceng234er13.s1.ref1">Hoskin 2019 (SCORAD-III trial)</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>Australia and United Kingdom</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=686.</p>
|
|
<p>Patients with MRI or CT confirmed metastatic spinal cord compression.</p>
|
|
<p>Age, median, years (range): single fraction 70 (23 to 96); multiple fraction 70 (33 to 95). Mean and SD not reported.</p>
|
|
<p>Sex: female n=183, male n=503.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Single fraction RT</u>
|
|
</p>
|
|
<p>8 Gy in 1 fraction beginning on day of simulation.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Multiple fraction RT</u>
|
|
</p>
|
|
<p>20 Gy in 5 fractions.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Health related quality of life</div></li><li class="half_rhythm"><div>Functional status</div></li><li class="half_rhythm"><div>Overall survival</div></li><li class="half_rhythm"><div>Pain</div></li><li class="half_rhythm"><div>Treatment related morbidity</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng234er13.s1.ref2" rid="niceng234er13.s1.ref2">Howell 2013</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>United States</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=235.</p>
|
|
<p>Patients with painful spinal metastases.</p>
|
|
<p>Age, median, years (range): Single fraction 69 (36 to 92); multiple fraction 68 (33 to 91). Mean and SD not reported.</p>
|
|
<p>Sex: female n=105, male n=129.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Single fraction RT</u>
|
|
</p>
|
|
<p>8 Gy in 1 fraction.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Multiple fraction RT</u>
|
|
</p>
|
|
<p>30 Gy in 10 fractions.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Survival</div></li><li class="half_rhythm"><div>Pain</div></li><li class="half_rhythm"><div>Treatment related morbidity</div></li><li class="half_rhythm"><div>Treatment failure</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng234er13.s1.ref3" rid="niceng234er13.s1.ref3">Lee 2018 (ICORG 05-03 trial)</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>Ireland and Northern Ireland</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=104.</p>
|
|
<p>Patients with MRI documented metastatic spinal cord compression/cauda equina not proceeding with surgical decompression.</p>
|
|
<p>Age, mean, years (SD): 66.7 (13.1) (not reported by group).</p>
|
|
<p>Sex: female n=38, male n=66.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Single fraction RT</u>
|
|
</p>
|
|
<p>10 Gy in 1 fraction beginning on day of simulation.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Multiple fraction RT</u>
|
|
</p>
|
|
<p>20 Gy in 5 fractions beginning on day of simulation.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Health related quality of life</div></li><li class="half_rhythm"><div>Functional status</div></li><li class="half_rhythm"><div>Pain</div></li><li class="half_rhythm"><div>Treatment related morbidity</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng234er13.s1.ref4" rid="niceng234er13.s1.ref4">Majumder 2012</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>India</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=64.</p>
|
|
<p>Patients with histopathologically proven primary malignancy having symptomatic secondary deposits to the vertebra.</p>
|
|
<p>Age, median, years (range): multiple fraction 58 (55.64); single fraction 60 (56.64). Mean and SD not reported.</p>
|
|
<p>Sex: female n=11, male n=53.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Single fraction RT</u>
|
|
</p>
|
|
<p>8 Gy in 1 fraction.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Multiple fraction RT</u>
|
|
</p>
|
|
<p>30 Gy in 10 fractions.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Pain</div></li><li class="half_rhythm"><div>Treatment related morbidity</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng234er13.s1.ref5" rid="niceng234er13.s1.ref5">Maranzano 2005</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>Italy</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=300 randomised (n=276 assessable).</p>
|
|
<p>Patients with MRI or CT diagnosed metastatic spinal cord compression and short life expectancy.</p>
|
|
<p>Age, median, years (range): short course 66 (30-87); split course 68 (34-89). Mean and SD not reported.</p>
|
|
<p>Sex: female n=85, male n=191.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Short course RT</u>
|
|
</p>
|
|
<p>16 Gy in 2 fractions over 1 week.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Split course RT</u>
|
|
</p>
|
|
<p>30 Gy in 8 fractions over 2 weeks.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Functional status</div></li><li class="half_rhythm"><div>Pain</div></li><li class="half_rhythm"><div>Survival</div></li><li class="half_rhythm"><div>Treatment related morbidity</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng234er13.s1.ref6" rid="niceng234er13.s1.ref6">Maranzano 2009</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>Italy</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=303.</p>
|
|
<p>Patients with MRI or CT confirmed metastatic spinal cord compression with a short life expectancy.</p>
|
|
<p>Age, median, years (range): single fraction 67 (33-87); multiple fraction 67 (39-87). Mean and SD not reported.</p>
|
|
<p>Sex: female n=106, male n=197.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Single fraction RT</u>
|
|
</p>
|
|
<p>8 Gy in 1 fraction.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Split course RT</u>
|
|
</p>
|
|
<p>16 Gy in 2 fractions.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Functional status</div></li><li class="half_rhythm"><div>Pain</div></li><li class="half_rhythm"><div>Bowel and bladder function</div></li><li class="half_rhythm"><div>Overall survival</div></li><li class="half_rhythm"><div>Treatment related morbidity</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng234er13.s1.ref7" rid="niceng234er13.s1.ref7">Patchell 2005</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>United States</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=101.</p>
|
|
<p>Patients with metastatic spinal cord compression.</p>
|
|
<p>Age, median, years (range): Surgery + RT 60; RT only 60. No further details reported.</p>
|
|
<p>Sex: female n=31, male n=70.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Surgery plus radiotherapy</u>
|
|
</p>
|
|
<p>Direct decompressive surgery within 24 hours of randomisation followed by RT (30 Gy in 10 fractions administered 14 days after surgery).</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Radiotherapy only</u>
|
|
</p>
|
|
<p>30 Gy in 10 fractions beginning within 24 hours of randomisation.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Mobility or ambulatory status</div></li><li class="half_rhythm"><div>Overall survival</div></li><li class="half_rhythm"><div>Functional status</div></li><li class="half_rhythm"><div>Bowel and bladder function</div></li><li class="half_rhythm"><div>Pain</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><a class="bibr" href="#niceng234er13.s1.ref8" rid="niceng234er13.s1.ref8">Rades 2016</a>, <a class="bibr" href="#niceng234er13.s1.ref9" rid="niceng234er13.s1.ref9">Rades 2018</a>, <a class="bibr" href="#niceng234er13.s1.ref10" rid="niceng234er13.s1.ref10">Rades 2019 (SCORE-2 trial)</a></p>
|
|
<p>RCT</p>
|
|
<p>Germany</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=203.</p>
|
|
<p>Patients with MRI or CT confirmed metastatic spinal cord compression but no previous surgery or radio-therapy to spinal cord.</p>
|
|
<p>Poor or intermediate survival prognosis.</p>
|
|
<p>Age, years, n: ≤ 68 n=103, ≥ 68 n=100. Mean and SD not reported.</p>
|
|
<p>Sex: female n=79, male n=124.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<u>20 Gy in 5 fractions</u>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<u>30 Gy in 10 fractions</u>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Functional status</div></li><li class="half_rhythm"><div>Pain</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng234er13.s1.ref11" rid="niceng234er13.s1.ref11">Roos 2005 (TROG 96-05 trial)</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>Australia, New Zealand, United Kingdom</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=272.</p>
|
|
<p>Patients with painful spinal metastases and life expectancy of at least 6 weeks.</p>
|
|
<p>Age, median, years (range): single fraction 67 (29-86); multiple fraction 68 (32-89). Mean and SD not reported.</p>
|
|
<p>Sex: female n=76, male n=196.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Single fraction RT</u>
|
|
</p>
|
|
<p>8 Gy in 1 fraction.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Multiple fraction RT</u>
|
|
</p>
|
|
<p>20 Gy in 5 fractions.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Pain</div></li><li class="half_rhythm"><div>Treatment failure</div></li><li class="half_rhythm"><div>Adverse events</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng234er13.s1.ref12" rid="niceng234er13.s1.ref12">Sahgal 2021</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>Canada and Australia</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=229.</p>
|
|
<p>Patients with painful MRI-confirmed spinal metastases.</p>
|
|
<p>Age, n: 18 to 59 n=83; 60 to 69 n=61; ≥70: n=85.</p>
|
|
<p>Sex: female n=109, male n=120.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Stereotactic ablative body RT</u>
|
|
</p>
|
|
<p>24 Gy in 2 consecutive daily fractions.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Conventional RT</u>
|
|
</p>
|
|
<p>20 Gy in 5 daily fractions.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Health related quality of life</div></li><li class="half_rhythm"><div>Overall survival</div></li><li class="half_rhythm"><div>Progression free survival</div></li><li class="half_rhythm"><div>Pain</div></li><li class="half_rhythm"><div>Treatment related morbidity</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><a class="bibr" href="#niceng234er13.s1.ref13" rid="niceng234er13.s1.ref13">Sprave 2018a</a>, <a class="bibr" href="#niceng234er13.s1.ref14" rid="niceng234er13.s1.ref14">b</a>, <a class="bibr" href="#niceng234er13.s1.ref15" rid="niceng234er13.s1.ref15">c (IRON-1 trial)</a></p>
|
|
<p>RCT</p>
|
|
<p>Germany</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=60.</p>
|
|
<p>Patients with spinal metastases with indication for palliative radio-therapy.</p>
|
|
<p>Age, mean, years (SD): IMRT: 66.1 (10.5); conventional RT: 62.5 (11.8).</p>
|
|
<p>Sex: female n=27, male n=33.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Image guided intensity modulated RT (IMRT)</u>
|
|
</p>
|
|
<p>30 Gy in 10 fractions.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Conventional RT</u>
|
|
</p>
|
|
<p>30 Gy in 10 fractions</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Health related quality of life</div></li><li class="half_rhythm"><div>Functional status</div></li><li class="half_rhythm"><div>Pain</div></li><li class="half_rhythm"><div>Treatment related morbidity</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><a class="bibr" href="#niceng234er13.s1.ref16" rid="niceng234er13.s1.ref16">Sprave 2018d</a>, <a class="bibr" href="#niceng234er13.s1.ref17" rid="niceng234er13.s1.ref17">e</a>, <a class="bibr" href="#niceng234er13.s1.ref18" rid="niceng234er13.s1.ref18">f (NCT-02358720)</a></p>
|
|
<p>RCT</p>
|
|
<p>Germany</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=55</p>
|
|
<p>Histologically confirmed tumour diagnosis, with secondary diagnosed solitary/multiple spinal bone metastases and indication for radio-therapy of the spinal bone metastases.</p>
|
|
<p>Age, mean, years (SD): Stereotactic body RT 61 (8.2); conventional RT 63.9 (10.8).</p>
|
|
<p>Sex: female n=27, male n=28.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Stereotactic ablative body RT</u>
|
|
</p>
|
|
<p>High dose singlefraction stereotactic ablative body radiation therapy (24 Gy to the 80% isodose line).</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Conventional RT</u>
|
|
</p>
|
|
<p>30 Gy in 10 fractions.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Health related quality of life</div></li><li class="half_rhythm"><div>Functional status</div></li><li class="half_rhythm"><div>Pain</div></li><li class="half_rhythm"><div>Treatment related morbidity</div></li></ul>
|
|
</td></tr><tr><td headers="hd_h_niceng234er13.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng234er13.s1.ref19" rid="niceng234er13.s1.ref19">Steenland 1999 (Dutch Bone Metastasis trial)</a>
|
|
</p>
|
|
<p>RCT</p>
|
|
<p>Netherlands</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N=1157.</p>
|
|
<p>Patients with painful bone metastases from a solid tumour.</p>
|
|
<p>Age, mean, years (SD): single fraction 65 (SD not reported); multiple fraction 65 (SD not reported).</p>
|
|
<p>Sex: female n=533, male n=624.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Single fraction RT</u>
|
|
</p>
|
|
<p>8 Gy in 1 fraction<u>.</u></p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<u>Multiple fraction RT</u>
|
|
</p>
|
|
<p>24 Gy in 6 fractions.</p>
|
|
</td><td headers="hd_h_niceng234er13.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Treatment related morbidity</div></li></ul>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">CT: computed tomography; Gy: Gray; IMRT: image guided intensity modulated radiotherapy; RCT: randomised controlled trial; MRI, magnetic resonance imaging; RT: radiotherapy, SD: standard deviation.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng234er13tab3"><div id="niceng234er13.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Economic evidence profile of an economic evaluation of the addition of radiotherapy for people undergoing surgery for metastatic spinal cord compression</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595812/table/niceng234er13.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng234er13.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng234er13.tab3_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng234er13.tab3_1_1_1_1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng234er13.tab3_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng234er13.tab3_1_1_1_2" style="text-align:left;vertical-align:bottom;">Limitations</th><th id="hd_h_niceng234er13.tab3_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng234er13.tab3_1_1_1_3" style="text-align:left;vertical-align:bottom;">Applicability</th><th id="hd_h_niceng234er13.tab3_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng234er13.tab3_1_1_1_4" style="text-align:left;vertical-align:bottom;">Other comments</th><th id="hd_h_niceng234er13.tab3_1_1_1_5" colspan="3" rowspan="1" style="text-align:center;vertical-align:bottom;">Incremental</th><th id="hd_h_niceng234er13.tab3_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng234er13.tab3_1_1_1_6" style="text-align:left;vertical-align:bottom;">Uncertainty</th></tr><tr><th headers="hd_h_niceng234er13.tab3_1_1_1_5" id="hd_h_niceng234er13.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Costs</th><th headers="hd_h_niceng234er13.tab3_1_1_1_5" id="hd_h_niceng234er13.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Effect</th><th headers="hd_h_niceng234er13.tab3_1_1_1_5" id="hd_h_niceng234er13.tab3_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost effectivenss</th></tr></thead><tbody><tr><td headers="hd_h_niceng234er13.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><a class="bibr" href="#niceng234er13.s1.ref20" rid="niceng234er13.s1.ref20">Turner 2018</a> Surgery and radio-therapy versus radio-therapy</td><td headers="hd_h_niceng234er13.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Potentially serious limitations<sup>1</sup></td><td headers="hd_h_niceng234er13.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Directly applicable<sup>2</sup></td><td headers="hd_h_niceng234er13.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Radiotherapy arm was based on modelling using values from <a class="bibr" href="#niceng234er13.s1.ref7" rid="niceng234er13.s1.ref7">Patchell 2005</a></td><td headers="hd_h_niceng234er13.tab3_1_1_1_5 hd_h_niceng234er13.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">− £12,839</td><td headers="hd_h_niceng234er13.tab3_1_1_1_5 hd_h_niceng234er13.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0.32 QALYs</td><td headers="hd_h_niceng234er13.tab3_1_1_1_5 hd_h_niceng234er13.tab3_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Surgery and radiotherpay dominant<sup>3</sup></td><td headers="hd_h_niceng234er13.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Various deterministic sensitivity analyses always favoured surgery and radiotherapy</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="niceng234er13.tab3_1"><p class="no_margin">Limited exploration of uncertainty.</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="niceng234er13.tab3_2"><p class="no_margin">UK NHS perspective with QALYs valued using EQ-5D questionnaire scored using the UK population value set</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="niceng234er13.tab3_3"><p class="no_margin">Surgery and radiotherapy both less costly and more effective</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng234er13appjtab1"><div id="niceng234er13.appj.tab1" class="table"><h3><span class="label">Table 14</span><span class="title">Excluded studies and reasons for their exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595812/table/niceng234er13.appj.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng234er13.appj.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
(2013) Xofigo (radium-223 dichloride; Bayer HealthCare Pharmaceuticals Inc.) for treatment of bone metastases in castration-resistant prostate cancer. Lansdale, PA: HAYES, Inc
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type does not match review protocol – conference abstract</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
(2011) Robotically assisted stereotactic radiosurgery (SRS) for spinal and extracranial head and neck indications. Lansdale, PA: HAYES, Inc
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type does not match review protocol – conference abstract</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Amouzegar-Hashemi, F, Behrouzi, H, Kazemian, A
|
|
et al. (2008) Single versus multiple fractions of palliative radiotherapy for bone metastases: a randomized clinical trial in Iranian patients. Current oncology (toronto, ont.)
|
|
15(3): 36–39 [<a href="/pmc/articles/PMC2442760/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2442760</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/18596887" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18596887</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bakar, D., Tanenbaum, J. E., Phan, K.
|
|
et al. (2016) Decompression surgery for spinal metastases: a systematic review. Neurosurgical Focus
|
|
41: e2 [<a href="https://pubmed.ncbi.nlm.nih.gov/27476844" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27476844</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Barrie, U., Elguindy, M., Pernik, M.
|
|
et al. (2020) Intramedullary Spinal Metastatic Renal Cell Carcinoma: Systematic Review of Disease Presentation, Treatment, and Prognosis with Case Illustration. World Neurosurgery
|
|
134: 584–593 [<a href="https://pubmed.ncbi.nlm.nih.gov/31734421" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31734421</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bilsky, M. H.; Laufer, I.; Burch, S. (2009) Shifting paradigms in the treatment of metastatic spine disease. Spine
|
|
34: S101–7 [<a href="https://pubmed.ncbi.nlm.nih.gov/19829269" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19829269</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Broder, M. S., Gutierrez, B., Cherepanov, D.
|
|
et al. (2015) Burden of skeletal-related events in prostate cancer: unmet need in pain improvement. Supportive Care in Cancer
|
|
23(1): 237–247 [<a href="https://pubmed.ncbi.nlm.nih.gov/25270847" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25270847</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cellini, F., Manfrida, S., Deodato, F.
|
|
et al. (2019) Pain REduction with bone metastases STereotactic radiotherapy (PREST): A phase III randomized multicentric trial. Trials
|
|
20(1) [<a href="/pmc/articles/PMC6816218/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6816218</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31661034" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31661034</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type does not match review protocol – study protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chang, J. H., Shin, J. H., Yamada, Y. J.
|
|
et al. (2016) Stereotactic Body Radiotherapy for Spinal Metastases: What are the Risks and How Do We Minimize Them?. Spine
|
|
41suppl20: S238–S245 [<a href="/pmc/articles/PMC5552170/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5552170</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27488294" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27488294</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chen, B., Xiao, S., Tong, X.
|
|
et al. (2015) Comparison of the Therapeutic Efficacy of Surgery with or without Adjuvant Radiotherapy versus Radiotherapy Alone for Metastatic Spinal Cord Compression: A Meta-Analysis. World Neurosurgery
|
|
83(6): 1066–1073 [<a href="https://pubmed.ncbi.nlm.nih.gov/25536156" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25536156</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chi, J. H., Gokaslan, Z., McCormick, P.
|
|
et al. (2009) Selecting treatment for patients with malignant epidural spinal cord compressiondoes age matter? Results from a randomized clinical trial. Spine
|
|
34(5): 431–435 [<a href="https://pubmed.ncbi.nlm.nih.gov/19212272" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19212272</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other protocol criteria - posthoc analysis of <a class="bibr" href="#niceng234er13.s1.ref7" rid="niceng234er13.s1.ref7">Patchell 2005</a> trial</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chow, E., Harris, K., Fan, G.
|
|
et al. (2007) Palliative radiotherapy trials for bone metastases: a systematic review. Journal of Clinical Oncology
|
|
25: 1423–36 [<a href="https://pubmed.ncbi.nlm.nih.gov/17416863" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17416863</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chow, E., Hoskin, P. J., Wu, J.
|
|
et al. (2006) A phase III international randomised trial comparing single with multiple fractions for re-irradiation of painful bone metastases: National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) SC 20. Clinical Oncology
|
|
18(2): 125–128 [<a href="https://pubmed.ncbi.nlm.nih.gov/16523812" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16523812</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chow, E., van der Linden, Y. M., Roos, D.
|
|
et al. (2014) Single versus multiple fractions of repeat radiation for painful bone metastases: a randomised, controlled, non-inferiority trial. Lancet Oncology
|
|
15: 164–71 [<a href="https://pubmed.ncbi.nlm.nih.gov/24369114" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24369114</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chow, E., Zeng, L., Salvo, N.
|
|
et al. (2012) Update on the systematic review of palliative radiotherapy trials for bone metastases. Clinical Oncology (Royal College of Radiologists)
|
|
24: 112–24 [<a href="https://pubmed.ncbi.nlm.nih.gov/22130630" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22130630</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dhamija, B.; Batheja, D.; Balain, B. S. (2021) A systematic review of MIS and open decompression surgery for spinal metastases in the last two decades. Journal of Clinical Orthopaedics & Trauma
|
|
22: 101596 [<a href="/pmc/articles/PMC8488238/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8488238</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34631409" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34631409</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Donovan, E. K., Sienna, J., Mitera, G.
|
|
et al. (2019) Single versus multifraction radiotherapy for spinal cord compression: A systematic review and meta-analysis. Radiotherapy & Oncology
|
|
134: 55–66 [<a href="https://pubmed.ncbi.nlm.nih.gov/31005225" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31005225</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dy, S. M., Asch, S. M., Naeim, A.
|
|
et al. (2008) Evidence-based standards for cancer pain management. Journal of Clinical Oncology
|
|
26(23): 3879–3885 [<a href="https://pubmed.ncbi.nlm.nih.gov/18688056" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18688056</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Falkmer, U., Jarhult, J., Wersall, P.
|
|
et al. (2003) A systematic overview of radiation therapy effects in skeletal metastases. Acta Oncologica
|
|
42(5–6): 620–633 [<a href="https://pubmed.ncbi.nlm.nih.gov/14596519" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14596519</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Feyer, P., Sautter-Bihl, M. L., Budachs, W.
|
|
et al. (2010) DEGRO practical guidelines for palliative radiotherapy of breast cancer patients: Brain metastases and leptomeningeal carcinomatosis. Strahlentherapie und Onkologie
|
|
186(2): 63–69 [<a href="https://pubmed.ncbi.nlm.nih.gov/20127222" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20127222</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Garcia-Torralba, E., Spada, F., Lim, K. H. J.
|
|
et al. (2021) Knowns and unknowns of bone metastases in patients with neuroendocrine neoplasms: A systematic review and meta-analysis. Cancer Treatment Reviews
|
|
94 (no pagination) [<a href="https://pubmed.ncbi.nlm.nih.gov/33730627" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33730627</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
George, R, Sundararaj, JJ, Govindaraj, R
|
|
et al. (2015) Interventions for the treatment of metastatic extradural spinal cord compression in adults. Cochrane Database of Systematic Reviews [<a href="/pmc/articles/PMC6513178/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6513178</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26337716" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26337716</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gerszten, P. C.; Mendel, E.; Yamada, Y. (2009) Radiotherapy and radiosurgery for metastatic spine disease: what are the options, indications, and outcomes?. Spine
|
|
34: S78–92 [<a href="https://pubmed.ncbi.nlm.nih.gov/19829280" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19829280</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ghia, A. J., Chang, E. L., Bishop, A. J.
|
|
et al. (2016) Single-fraction versus multifraction spinal stereotactic radiosurgery for spinal metastases from renal cell carcinoma: secondary analysis of Phase I/II trials. Journal of Neurosurgery Spine
|
|
24: 829–36 [<a href="https://pubmed.ncbi.nlm.nih.gov/26799117" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26799117</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design - phase I or II trials - patients not randomly allocated to treatment</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Glicksman, R. M., Tjong, M. C., Neves-Junior, W. F. P.
|
|
et al. (2020) Stereotactic Ablative Radiotherapy for the Management of Spinal Metastases: A Review. JAMA Oncology
|
|
6: 567–577 [<a href="https://pubmed.ncbi.nlm.nih.gov/31895403" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31895403</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gong, Y., Xu, L., Zhuang, H.
|
|
et al. (2019) Efficacy and safety of different fractions in stereotactic body radiotherapy for spinal metastases: A systematic review. Cancer Medicine
|
|
8: 6176–6184 [<a href="/pmc/articles/PMC6797563/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6797563</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31489788" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31489788</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Goodwin, C. R., Sankey, E. W., Liu, A.
|
|
et al. (2016) A systematic review of clinical outcomes for patients diagnosed with skin cancer spinal metastases. Journal of Neurosurgery: Spine
|
|
24(5): 837–849 [<a href="https://pubmed.ncbi.nlm.nih.gov/26544595" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26544595</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hamouda, W. E.; Roshdy, W.; Teema, M. (2007) Single versus conventional fractionated radiotherapy in the palliation of painful bone metastases. The gulf journal of oncology
|
|
1: 35–41 [<a href="https://pubmed.ncbi.nlm.nih.gov/20084712" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20084712</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hernandez-Duran, S., Hanft, S., Komotar, R. J.
|
|
et al. (2016) The role of stereotactic radiosurgery in the treatment of intramedullary spinal cord neoplasms: a systematic literature review. Neurosurgical Review
|
|
39(2): 175–183 [<a href="https://pubmed.ncbi.nlm.nih.gov/26219855" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26219855</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Holt, T., Hoskin, P., Maranzano, E.
|
|
et al. (2012) Malignant epidural spinal cord compression: the role of external beam radiotherapy. Current Opinion in Supportive & Palliative Care
|
|
6: 103–8 [<a href="https://pubmed.ncbi.nlm.nih.gov/22156794" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22156794</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match review protocol – expert review/narrative</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Howell, DD, James, JL, Hartsell, WF
|
|
et al. (2009) Randomized trial of short-course versus long-course radiotherapy for palliation of painful vertebral bone metastases: a retrospective analysis of RTOG 97-14. Journal of clinical oncology
|
|
27(15sparti): 488
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type does not match review protocol – conference abstract</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Husain, Z. A., Sahgal, A., De Salles, A.
|
|
et al. (2017) Stereotactic body radiotherapy for de novo spinal metastases: systematic review. Journal of Neurosurgery Spine
|
|
27: 295–302 [<a href="https://pubmed.ncbi.nlm.nih.gov/28598293" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28598293</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jeremic, B. (2001) Single fraction external beam radiation therapy in the treatment of localized metastatic bone pain. A review. Journal of Pain and Symptom Management
|
|
22(6): 1048–1058 [<a href="https://pubmed.ncbi.nlm.nih.gov/11738168" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11738168</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jeremic, B, Shibamoto, Y, Acimovic, L
|
|
et al. (1998) A randomized trial of three single-dose radiation therapy regimens in the treatment of metastatic bone pain. International journal of radiation oncology, biology, physics
|
|
42(1): 161–167 [<a href="https://pubmed.ncbi.nlm.nih.gov/9747834" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9747834</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kim, J. M., Losina, E., Bono, C. M.
|
|
et al. (2012) Clinical outcome of metastatic spinal cord compression treated with surgical excision +/- radiation versus radiation therapy alone: a systematic review of literature. Spine
|
|
37: 78–84 [<a href="/pmc/articles/PMC3876411/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3876411</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21629164" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21629164</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Klimo
|
|
Jr, P., Thompson, C. J., Kestle, J. R. W.
|
|
et al. (2005) A meta-analysis of surgery versus conventional radiotherapy for the treatment of metastatic spinal epidural disease. Neuro-Oncology
|
|
7(1): 64–76 [<a href="/pmc/articles/PMC1871618/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1871618</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15701283" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15701283</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparator do not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kumar, N., Madhu, S., Bohra, H.
|
|
et al. (2020) Is there an optimal timing between radiotherapy and surgery to reduce wound complications in metastatic spine disease? A systematic review. European Spine Journal
|
|
29: 3080–3115 [<a href="https://pubmed.ncbi.nlm.nih.gov/32556627" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32556627</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes do not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee, C. H., Kwon, J. W., Lee, J.
|
|
et al. (2014) Direct decompressive surgery followed by radiotherapy versus radiotherapy alone for metastatic epidural spinal cord compression: a meta-analysis. Spine
|
|
39: E587–92 [<a href="https://pubmed.ncbi.nlm.nih.gov/24503688" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24503688</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Leer, JWH; Steenland, E; van Houwelingen, H (1999) Pain control for bone metastases. European journal of cancer
|
|
35(abstract462): 129
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type does not match review protocol – conference abstract</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Loblaw, D. A. and Laperriere, N. J. (1998) Emergency treatment of malignant extradural spinal cord compression: An evidence-based guideline. Journal of Clinical Oncology
|
|
16(4): 1613–1624 [<a href="https://pubmed.ncbi.nlm.nih.gov/9552073" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9552073</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type does not match review protocol – duplicate publication - updated version available</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Loblaw, D. A., Mitera, G., Ford, M.
|
|
et al. (2012) A 2011 updated systematic review and clinical practice guideline for the management of malignant extradural spinal cord compression. International Journal of Radiation Oncology, Biology, Physics
|
|
84: 312–7 [<a href="https://pubmed.ncbi.nlm.nih.gov/22420969" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22420969</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Loblaw, D. A., Perry, J., Chambers, A.
|
|
et al. (2005) Systematic review of the diagnosis and management of malignant extradural spinal cord compression: the Cancer Care Ontario Practice Guidelines Initiative’s Neuro-Oncology Disease Site Group. Journal of Clinical Oncology
|
|
23: 2028–37 [<a href="https://pubmed.ncbi.nlm.nih.gov/15774794" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15774794</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type does not match review protocol – duplicate publication - updated version available</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lohre, E. T.; Lund, J.; Kaasa, S. (2012) Radiation therapy in malignant spinal cord compression: what is the current knowledge on fractionation schedules? A systematic literature review. BMJ supportive & palliative care
|
|
2(1): 51–56 [<a href="https://pubmed.ncbi.nlm.nih.gov/24653500" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24653500</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lutz, S., Balboni, T., Jones, J.
|
|
et al. (2017) Palliative radiation therapy for bone metastases: Update of an ASTRO Evidence-Based Guideline. Practical Radiation Oncology
|
|
7: 4–12 [<a href="https://pubmed.ncbi.nlm.nih.gov/27663933" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27663933</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ma, Y., He, S., Liu, T.
|
|
et al. (2017) Quality of Life of Patients with Spinal Metastasis from Cancer of Unknown Primary Origin: A Longitudinal Study of Surgical Management Combined with Postoperative Radiation Therapy. Journal of Bone & Joint Surgery - American Volume
|
|
99: 1629–1639 [<a href="https://pubmed.ncbi.nlm.nih.gov/28976427" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28976427</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match review protocol – non-randomised study</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Maranzano, E., Trippa, F., Casale, M.
|
|
et al. (2011) Reirradiation of metastatic spinal cord compression: definitive results of two randomized trials. Radiotherapy & Oncology
|
|
98: 234–7 [<a href="https://pubmed.ncbi.nlm.nih.gov/21295881" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21295881</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match review protocol - post-hoc analysis (patients not randomised to re-treatment with radiotherapy)</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Migliorini, F., Eschweiler, J., Trivellas, A.
|
|
et al. (2021) Better pain control with 8-gray single fraction palliative radiotherapy for skeletal metastases: a Bayesian network meta-analysis. Clinical and Experimental Metastasis
|
|
38(2): 197–208 [<a href="/pmc/articles/PMC7987640/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7987640</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33559808" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33559808</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Moller, T. (1996) Skeletal metastases. Acta oncologica (Stockholm, Sweden)
|
|
35suppl7: 125–136 [<a href="https://pubmed.ncbi.nlm.nih.gov/9154105" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9154105</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Moulding, H. D. and Bilsky, M. H. (2010) Metastases to the craniovertebral junction. Neurosurgery
|
|
66(SUPPL. 3): A113–A118 [<a href="https://pubmed.ncbi.nlm.nih.gov/20173512" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20173512</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Myrehaug, S., Sahgal, A., Hayashi, M.
|
|
et al. (2017) Reirradiation spine stereotactic body radiation therapy for spinal metastases: systematic review. Journal of Neurosurgery Spine
|
|
27: 428–435 [<a href="https://pubmed.ncbi.nlm.nih.gov/28708043" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28708043</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Niewald, M., Tkocz, H. J., Abel, U.
|
|
et al. (1996) Rapid course radiation therapy vs. more standard treatment: a randomized trial for bone metastases. International Journal of Radiation Oncology, Biology, Physics
|
|
36: 1085–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/8985030" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8985030</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol - data for spinal metastases group not reported</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ozsaran, Z, Yalman, D, Anacak, Y
|
|
et al. (2001) Palliative radiotherapy in bone metastases: results of a randomized trial comparing three fractionation schedules. Journal of B.U.ON. 6(1): 43–48
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Pontoriero, A., Lillo, S., Caravatta, L.
|
|
et al. (2021) Cumulative dose, toxicity, and outcomes of spinal metastases re-irradiation: Systematic review on behalf of the Re-Irradiation Working Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO). Strahlentherapie und Onkologie
|
|
197: 369–384 [<a href="https://pubmed.ncbi.nlm.nih.gov/33635395" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33635395</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Qu, S., Meng, H. L., Liang, Z. G.
|
|
et al. (2015) Comparison of shortcourse radiotherapy versus long-course radiotherapy for treatment of metastatic spinal cord compression: A systematic review and meta-analysis. Medicine (United States)
|
|
94(43) [<a href="/pmc/articles/PMC4985404/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4985404</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26512590" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26512590</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Quraishi, N. A., Giannoulis, K. E., Edwards, K. L.
|
|
et al. (2012) Management of metastatic sacral tumours. European Spine Journal
|
|
21: 1984–93 [<a href="/pmc/articles/PMC3463705/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3463705</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22729363" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22729363</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rades, D. (2010) Dose-fractionation schedules for radiotherapy of bone metastases. Breast Care
|
|
5(5): 339–344 [<a href="/pmc/articles/PMC3132960/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3132960</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21779218" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21779218</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rades, D., Cacicedo, J., Conde-Moreno, A. J.
|
|
et al. (2021) Comparison of 5 x 5 Gy and 10 x 3 Gy for metastatic spinal cord compression using data from three prospective trials. Radiation Oncology
|
|
16: 7 [<a href="/pmc/articles/PMC7788916/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7788916</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33413492" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33413492</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Patients were not randomly allocated to treatment groups</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rich, S. E., Chow, R., Raman, S.
|
|
et al. (2018) Update of the systematic review of palliative radiation therapy fractionation for bone metastases. Radiotherapy & Oncology
|
|
126: 547–557 [<a href="https://pubmed.ncbi.nlm.nih.gov/29397209" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29397209</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Roos, D. E., O’Brien, P. C., Smith, J. G.
|
|
et al. (2000) A role for radiotherapy in neuropathic bone pain: preliminary response rates from a prospective trial (Trans-tasman radiation oncology group, TROG 96.05). International Journal of Radiation Oncology, Biology, Physics
|
|
46: 975–81 [<a href="https://pubmed.ncbi.nlm.nih.gov/10705020" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10705020</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other protocol criteria - data from preliminary analysis reported in <a class="bibr" href="#niceng234er13.s1.ref11" rid="niceng234er13.s1.ref11">Roos 2005</a> which has been included in this review</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Roos, D. E., Davis, S. R., Turner, S. L.
|
|
et al. (2003) Quality assurance experience with the randomized neuropathic bone pain trial (Trans-Tasman Radiation Oncology Group, 96.05). Radiotherapy & Oncology
|
|
67: 207–12 [<a href="https://pubmed.ncbi.nlm.nih.gov/12812852" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12812852</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol - data for spinal metastases group not reported</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Roque i Figuls, M., Martinez-Zapata, M. J., Scott-Brown, M.
|
|
et al. (2017) Radioisotopes for metastatic bone pain. Cochrane Database of Systematic Reviews
|
|
2017(3) [<a href="/pmc/articles/PMC6464104/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6464104</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28334435" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28334435</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type does not match review protocol – duplicate publication - withdrawn version of a Cochrane review</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sahgal, A., Myrehaug, S. D., Siva, S.
|
|
et al. (2020) CCTG SC.24/TROG 17.06: A Randomized Phase II/III Study Comparing 24Gy in 2 Stereotactic Body Radiotherapy (SABR) Fractions Versus 20Gy in 5 Conventional Palliative Radiotherapy (CRT) Fractions for Patients with Painful Spinal Metastases. International journal of radiation oncology, biology, physics
|
|
108(5): 1397–1398 [<a href="https://pubmed.ncbi.nlm.nih.gov/33427654" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33427654</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type does not match review protocol – conference abstract</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sande, T. A., Ruenes, R., Lund, J. A.
|
|
et al. (2009) Long-term follow-up of cancer patients receiving radiotherapy for bone metastases: results from a randomised multicentre trial. Radiotherapy & Oncology
|
|
91: 261–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/19307034" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19307034</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sapkaroski, D.; Osborne, C.; Knight, K. A. (2015) A review of stereotactic body radiotherapy - is volumetric modulated arc therapy the answer?. Journal of Medical Radiation Sciences
|
|
62(2): 142–151 [<a href="/pmc/articles/PMC4462986/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4462986</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26229679" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26229679</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sharma, R., Sagoo, N. S., Haider, A. S.
|
|
et al. (2021) Iodine-125 radioactive seed brachytherapy as a treatment for spine and bone metastases: A systematic review and meta-analysis. Surgical Oncology
|
|
38 (no pagination) [<a href="https://pubmed.ncbi.nlm.nih.gov/34153905" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34153905</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Singh, R., Lehrer, E. J., Dahshan, B.
|
|
et al. (2020) Single fraction radiosurgery, fractionated radiosurgery, and conventional radiotherapy for spinal oligometastasis (SAFFRON): A systematic review and meta-analysis. Radiotherapy & Oncology
|
|
146: 76–89 [<a href="https://pubmed.ncbi.nlm.nih.gov/32114269" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32114269</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Smith, B. W., Joseph, J. R., Saadeh, Y. S.
|
|
et al. (2018) Radiosurgery for Treatment of Renal Cell Metastases to Spine: A Systematic Review of the Literature. World Neurosurgery
|
|
109: e502–e509 [<a href="https://pubmed.ncbi.nlm.nih.gov/29038086" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29038086</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sohn, S. and Chung, C. K. (2012) The role of stereotactic radiosurgery in metastasis to the spine. Journal of Korean Neurosurgical Society
|
|
51: 1–7 [<a href="/pmc/articles/PMC3291699/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3291699</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22396835" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22396835</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Soltys, S. G., Grimm, J., Milano, M. T.
|
|
et al. (2021) Stereotactic Body Radiation Therapy for Spinal Metastases: Tumor Control Probability Analyses and Recommended Reporting Standards. International Journal of Radiation Oncology, Biology, Physics
|
|
110: 112–123 [<a href="https://pubmed.ncbi.nlm.nih.gov/33516580" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33516580</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Souchon, R., Wenz, F., Sedlmayer, F.
|
|
et al. (2009) DEGRO practice guidelines for palliative radiotherapy of metastatic breast cancer: bone metastases and metastatic spinal cord compression (MSCC). Strahlentherapie und Onkologie
|
|
185: 417–24 [<a href="https://pubmed.ncbi.nlm.nih.gov/19714302" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19714302</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Stebbing, J. and Ngan, S. (2010) Breast cancer (metastatic). BMJ clinical evidence [<a href="/pmc/articles/PMC3217794/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3217794</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21418674" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21418674</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Suppli, MH, Munck Af Rosenschold, P, Dahl, B
|
|
et al. (2020) Premature Termination of a Randomized Controlled Trial on Image-Guided Stereotactic Body Radiotherapy of Metastatic Spinal Cord Compression. Oncologist
|
|
25(3): 210–e422 [<a href="/pmc/articles/PMC7066690/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7066690</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32162821" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32162821</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes do not match review protocol – no outcomes reported (trial was closed prematurely)</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sze, W. M., Shelley, M., Held, I.
|
|
et al. (2004) Palliation of metastatic bone pain: single fraction versus multifraction radiotherapy - a systematic review of the randomised trials. Cochrane Database of Systematic Reviews: cd004721 [<a href="/pmc/articles/PMC6599833/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6599833</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15106258" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15106258</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Thirion, P. G., Dunne, M. T., Kelly, P. J.
|
|
et al. (2020) Non-inferiority randomised phase 3 trial comparing two radiation schedules (single vs. five fractions) in malignant spinal cord compression. British Journal of Cancer
|
|
122: 1315–1323 [<a href="/pmc/articles/PMC7188681/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7188681</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32157242" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32157242</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other protocol criteria - secondary publication of ICORG 05-03 trial (<a class="bibr" href="#niceng234er13.s1.ref3" rid="niceng234er13.s1.ref3">Lee 2018</a>), but no additional relevant outcome data reported that match the protocol for this review</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Trilling, G. M., Cho, H., Ugas, M. A.
|
|
et al. (2012) Spinal metastasis in head and neck cancer. Head and Neck Oncology
|
|
4(1) [<a href="/pmc/articles/PMC3448515/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3448515</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22716187" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22716187</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
van der Linden, YM, Dijkstra, SP, Vonk, EJ
|
|
et al. (2005) Prediction of survival in patients with metastases in the spinal column: results based on a randomized trial of radiotherapy. Cancer
|
|
103(2): 320–328 [<a href="https://pubmed.ncbi.nlm.nih.gov/15593360" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15593360</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Van Der Linden, YM, Steenland, E, Post, WJ
|
|
et al. (2002) Singledose irradiation of painful bone metastases is as effective as multiple fractions. Outcome of the Dutch Bone Metastasis Study. Nederlands tijdschrift voor geneeskunde
|
|
146(35): 1645–1650
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other protocol criteria – not available in English</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Verbiest, A., De Meerleer, G., Albersen, M.
|
|
et al. (2018) Non-surgical ablative treatment of distant extracranial metastases for renal cell carcinoma: A systematic review. Kidney Cancer
|
|
2(1): 57–67
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention does not match review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Westhoff, P. G., de Graeff, A., Monninkhof, E. M.
|
|
et al. (2018) Effectiveness and toxicity of conventional radiotherapy treatment for painful spinal metastases: a detailed course of side effects after opposing fields versus a single posterior field technique. Journal of Radiation Oncology
|
|
7: 17–26 [<a href="/pmc/articles/PMC5856865/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5856865</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29576859" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29576859</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wild, A. T. and Yamada, Y. (2017) Treatment Options in Oligometastatic Disease: Stereotactic Body Radiation Therapy - Focus on Colorectal Cancer. Visceral Medicine
|
|
33: 54–61 [<a href="/pmc/articles/PMC5465794/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5465794</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28612018" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28612018</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type does not match review protocol – expert review/narrative</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wowra, B, Zausinger, S, Muacevic, A
|
|
et al. (2009) Radiosurgery for spinal malignant tumors. Deutsches Aerzteblatt International
|
|
106(7): 106–112 [<a href="/pmc/articles/PMC2696242/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2696242</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19562022" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19562022</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match review protocol – expert review/narrative</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yang, J., Yan, J., Zeng, M.
|
|
et al. (2020) Bone metastases of gastrointestinal stromal tumor: A review of published literature. Cancer Management and Research
|
|
12: 1411–1417 [<a href="/pmc/articles/PMC7049741/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7049741</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32161493" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32161493</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yao, A., Sarkiss, C. A., Ladner, T. R.
|
|
et al. (2017) Contemporary spinal oncology treatment paradigms and outcomes for metastatic tumors to the spine: A systematic review of breast, prostate, renal, and lung metastases. Journal of Clinical Neuroscience
|
|
41: 11–23 [<a href="https://pubmed.ncbi.nlm.nih.gov/28462790" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28462790</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Young, RF; Post, EM; King, GA (1980) Treatment of spinal epidural metastases. Randomized prospective comparison of laminectomy and radiotherapy. Journal of neurosurgery
|
|
53(6): 741–748 [<a href="https://pubmed.ncbi.nlm.nih.gov/7441333" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7441333</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication date before cutoff in review protocol</td></tr><tr><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zuckerman, S. L., Lim, J., Yamada, Y.
|
|
et al. (2018) Brachytherapy in Spinal Tumors: A Systematic Review. World Neurosurgery
|
|
118: e235–e244 [<a href="https://pubmed.ncbi.nlm.nih.gov/29966796" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29966796</span></a>]
|
|
</td><td headers="hd_h_niceng234er13.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design does not match protocol criteria - systematic review without pooled results/quantitative data, checked for relevant studies</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
|
|
|
|
|
|
|
|
|
|
<!-- Book content -->
|
|
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/rlib/js/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js"> </script>
|
|
|
|
|
|
<!-- CE8B5AF87C7FFCB1_0191SID /projects/books/PBooks@9.11 portal105 v4.1.r689238 Tue, Oct 22 2024 16:10:51 -->
|
|
<span id="portal-csrf-token" style="display:none" data-token="CE8B5AF87C7FFCB1_0191SID"></span>
|
|
|
|
<script type="text/javascript" src="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/js/3968615.js" snapshot="books"></script></body>
|
|
</html>
|