SynthesisSpine2016
Stereotactic Body Radiotherapy for Spinal Metastases: What are the Risks and How Do We Minimize Them?
Synthesis in Spine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
En Bloc Resection Versus Separation Surgery Combined With Radiotherapy for the Treatment of Spinal Oligometastatic Tumor-A Multi-center, Prospective, Randomized, Controlled Study.
Postoperative Radiotherapy Versus No Radiotherapy Following Separation Surgery for Spinal Metastases: A Mixed Cohort Study
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 81 citations in OpenAlex.
- Systematic Review of the Role of Stereotactic Radiotherapy for Bone Metastases.Journal of the National Cancer Institute · 2019Pooled it
- [Value of postoperative stereotaxic body radiation therapy for spinal metastases].Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2017Trial
- The transformative role of SBRT in the management of spinal metastases.Nature reviews. Clinical oncology · 2026Review
- Impact of dose reporting modes on dosimetric accuracy in a national end-to-end stereotactic spine radiotherapy audit.Physics and imaging in radiation oncology · 2026Article
- Risk Factors for Vertebral Compression Fracture Following Spine Stereotactic Body Radiation Therapy.Advances in radiation oncology · 2026Article
- Malignant melanotic nerve sheath tumor mimicking a benign nerve sheath lesion: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Initial Outcomes of Zap-X Stereotactic Radiosurgery for the Treatment of Spinal Tumors: A Case Series.Cureus · 2025Article
- Review
- Advanced Radiotherapy Technologies in Spine Tumors: What the Surgeon Needs to Know.Global spine journal · 2025Article
- Tumor treating fields suppress tumor cell growth and neurologic decline in models of spinal metastases.JCI insight · 2024Article
- Article
- Dosimetric impact of CT metal artifact reduction for spinal implants in stereotactic body radiotherapy planning.Quantitative imaging in medicine and surgery · 2023Article
- Extranodal classical Hodgkin lymphoma involving the spinal cord: case report and review of the literature.CNS oncology · 2022Review
- Personalized Automation of Treatment Planning for Linac-Based Stereotactic Body Radiotherapy of Spine Cancer.Frontiers in oncology · 2022Article
- Focused versus conventional radiotherapy in spinal oncology: is there any difference in fusion rates and pseudoarthrosis?Journal of neuro-oncology · 2022Article
- Comparison of Surgical Outcomes Between Separation Surgery and Piecemeal Spondylectomy for Spinal Metastasis: A Retrospective Analysis.Frontiers in surgery · 2021Article
- Local control of 1-5 fraction radiotherapy regimens for spinal metastases: an analysis of the impacts of biologically effective dose and primary histology.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2021Article
- The emergence of new prognostic scores in lung cancer patients with spinal metastasis: A 12-year single-center retrospective study.Journal of Cancer · 2021Article
- Separation surgery for metastatic epidural spinal cord compression: A qualitative review.Journal of bone oncology · 2020Review
- Stereotactic radiation therapy for breast cancer in the elderly.Translational cancer research · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
Abstract
STUDY
designSystematic literature review.
objectivesTo summarize the risks of 3 key complications of stereotactic body radiotherapy (SBRT) for spinal metastases, that is, radiation myelopathy (RM), vertebral compression fracture (VCF), and epidural disease progression, and to discuss strategies for minimizing them. SUMMARY OF BACKGROUND DATA: RM, VCF and epidural disease progression are now recognized as important risks following SBRT for spine metastases. It is unclear at this stage exactly how large these risks are and what strategies can be employed to minimize these risks.
methodsA systematic review of the literature using MEDLINE and a review of the bibliographies of reviewed articles on SBRT for spinal metastases were conducted.
resultsThe initial literature search revealed a total of 376 articles, of which 38 were pertinent to the study objectives. The risk of RM following SBRT was found to be dependent on the maximum dose to the spinal cord and estimated to be ≤5% if the recommended published thecal sac dose constraints are adhered to. The crude risk of VCF was 13.7% (range: 0.7%-40.5%), and, on average, 45% were surgically salvaged. It has been shown that the risk of VCF is dependent on several anatomic and tumor-related factors including the SBRT dose per fraction. The crude risk of local failure at 1 year was 21.4% (range: 12%-27%) of which 67% (range: 38%-96%) occurred within the epidural space. The grade of epidural disease has been shown to be associated with the risk of local failure.
conclusionThe risk of RM after spinal SBRT is low in particular if recommended dose metrics are adhered to. There is a significant risk of both VCF and epidural disease progression after spinal SBRT. These risks can potentially be minimized by identifying the risk factors for these complications, and performing careful radiotherapy and surgical planning. LEVEL OF EVIDENCE: 2.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.