Evidence map›Paper›PMID 33208170›Full record

ArticleRadiation oncology (London, England)2020

A pilot study of stereotactic boost for malignant epidural spinal cord compression: clinical significance and initial dosimetric evaluation.

Elysia K Donovan, Jeffrey Greenspoon, Kara L Schnarr, Timothy J Whelan, James R Wright, Crystal Hann, Anthony Whitton, Tom Chow, Sameer Parpia, Anand Swaminath

Registry-linked trialOpen access · goldAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Radiation oncology (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03529708 (Stereotactic Body Radiotherapy), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT03529708 naunknown statusnot on this map

Stereotactic Body Radiotherapy (SBRT) Boost Following Urgent 3D Conformal Radiotherapy in the Treatment of Metastatic Epidural Spinal Cord Compression (SCC): A Phase I Feasibility Trial

TypeinterventionalSponsorJuravinski Cancer CenterRan2018 to 2020Enrolled30ConditionsSpinal Cord Compression, Cauda Equina Syndrome, Stereotactic Body RadiotherapyArms3D CRT plus SBRT boost
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Quality of life in patients with malignant spinal cord compression: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
    Pooled it
  2. Article
  3. Randomized controlled trials in neurosurgery.Surgical neurology international · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Elysia K DonovanSunnybrook Odette Cancer Centre, Department of Radiation Oncology, University of Toronto, 2075 Bayview Avenue, T2 Wing, Toronto, ON, M4N3M5, Canada.
Jeffrey GreenspoonJuravinski Cancer Centre, Department of Radiation Oncology, McMaster University, 3rd Floor, 699 Concession Street, Hamilton, ON, L8V 5C2, Canada.
Kara L SchnarrJuravinski Cancer Centre, Department of Radiation Oncology, McMaster University, 3rd Floor, 699 Concession Street, Hamilton, ON, L8V 5C2, Canada.
Timothy J WhelanJuravinski Cancer Centre, Department of Radiation Oncology, McMaster University, 3rd Floor, 699 Concession Street, Hamilton, ON, L8V 5C2, Canada.
James R WrightJuravinski Cancer Centre, Department of Radiation Oncology, McMaster University, 3rd Floor, 699 Concession Street, Hamilton, ON, L8V 5C2, Canada.
Crystal HannJuravinski Cancer Centre, Department of Radiation Oncology, McMaster University, 3rd Floor, 699 Concession Street, Hamilton, ON, L8V 5C2, Canada.
Anthony WhittonJuravinski Cancer Centre, Department of Radiation Oncology, McMaster University, 3rd Floor, 699 Concession Street, Hamilton, ON, L8V 5C2, Canada.
Tom ChowJuravinski Cancer Centre, Department of Medical Physics, McMaster University, 4th Floor, 699 Concession Street, Hamilton, ON, L8V 5C2, Canada.
Sameer ParpiaJuravinski Cancer Centre, Department of Oncology, McMaster University, 1st Floor, 699 Concession Street, Hamilton, ON, L8V 5C2, Canada.
Anand SwaminathJuravinski Cancer Centre, Department of Radiation Oncology, McMaster University, 3rd Floor, 699 Concession Street, Hamilton, ON, L8V 5C2, Canada. swaminath@hhsc.ca.ORCID http://orcid.org/0000-0003-4013-1980
Juravinski Cancer Centre · CASunnybrook Health Science Centre · CA

Funding

Hamilton Health Sciences JCC Foundation GrantHamilton Health Sciences NIF Fund
6 · The paper itself

Abstract

purposeMetastatic epidural spinal cord compression (MESCC) is a devastating complication of advanced malignancy, which can result in neurologic complications and significant deterioration in overall function and quality of life. Most patients are not candidates for optimal surgical decompression and as a result, receive urgent 3D conformal radiotherapy (3DCRT) to prevent or attempt to reverse neurologic progression. Multiple trials indicate that response and ambulatory rates after 3DCRT are inferior to surgery. The advent of stereotactic body radiation therapy (SBRT) has created a method with which a "radiosurgical decompression" boost may facilitate improve outcomes for MESCC patients.

methodsWe are conducting a pilot study to investigate SBRT boost after urgent 3D CRT for patients with MESCC. The aim of the study is to establish feasibility of this two-phase treatment regimen, and secondarily to characterize post-treatment ambulation status, motor response, pain control, quality of life and survival. DISCUSSION: We describe the study protocol and present a case report of one patient. A quality assurance review was conducted after the first seven patients, and resultant dose-constraints were revised to improve safety and feasibility of planning through more conservative organ at risk constraints. There have been no severe adverse events (grade 3-5) to date. We have illustrated clinical and dosimetric data of an example case, where a patient regained full strength and ambulatory capacity.

conclusionsOur study aims to determine if SBRT is a feasible option in addition to standard 3DCRT for MESCC patients, with the goal to consider future randomized trials if successful. Having a robust quality assurance process in this study ensures translatability going forward if future trials with multicenter and increased patient representation are to be considered.

trial registrationclinicaltrials.gov; registration no. NCT03529708; https://clinicaltrials.gov/ct2/show/NCT03529708 ; First posted May 18, 2018.

Indexed as

Epidural NeoplasmsFemaleHumansMiddle AgedPilot ProjectsQuality Assurance, Health CareRadiosurgeryRadiotherapy, ConformalRadiotherapy DosageSpinal Cord CompressionPalliative radiationSpinal cord compressionStereotactic radiotherapy

Identifiers

PMID33208170
PMCPMC7672889
OpenAlexW3098799104

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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.