Evidence map›Paper›PMID 37143158›Full record

Trial reportTrials2023

Stereotactic Body radiotherapy and pedicLE screw fixatioN During one hospital visit for patients with symptomatic unstable spinal metastases: a randomized trial (BLEND RCT) using the Trials within Cohorts (TwiCs) design.

E H Huele, J M van der Velden, N Kasperts, W S C Eppinga, J P C Grutters, B B M Suelmann, A A Weening, D Delawi, S C C M Teunissen, H M Verkooijen and 2 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled TrialClinical Trial, Phase III
In one paragraph

Trial report in Trials, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05575323 (Stereotactic Body Radiotherapy and pedicLE Screw fixatioN During One Hospital Visit for Patients With Painful Unstable Spinal Metastases), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.2field-weighted citation impact, top 13% 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.

NCT05575323 narecruitingnot on this map

Stereotactic Body Radiotherapy and pedicLE Screw fixatioN During One Hospital Visit for Patients With Painful Unstable Spinal Metastases: A Randomized Trial (BLEND)

TypeinterventionalSponsorUMC UtrechtRan2022 to 2027Enrolled100ConditionsSpinal MetastasesArmsSame-day SBRT and spinal surgery, Standard of care
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
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

12 authors at 5 institutions in 1 country.

E H HueleDivision of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
J M van der VeldenDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
N KaspertsDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
W S C EppingaDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
J P C GruttersDepartment for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
B B M SuelmannDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
A A WeeningDepartment of Orthopedic Surgery, Diakonessenhuis, Utrecht, The Netherlands.
D DelawiDepartment of Orthopedic Surgery, St. Antoniusziekenhuis, Nieuwegein, The Netherlands.
S C C M TeunissenJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
H M VerkooijenDivision of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
J J VerlaanDepartment of Orthopedic Surgery, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands.
R GalDivision of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. R.Gal@umcutrecht.nl.ORCID http://orcid.org/0000-0001-7340-4581
Utrecht University · NLUniversity Medical Center Utrecht · NLDiakonessenhuis hospital · NLRadboud University Nijmegen · NLSt. Antonius Ziekenhuis · NL

Funding

ZonMw 08440012010003
6 · The paper itself

Abstract

backgroundSpinal metastases can lead to unremitting pain and neurological deficits, which substantially impair daily functioning and quality of life. Patients with unstable spinal metastases receive surgical stabilization followed by palliative radiotherapy as soon as wound healing allows. The time between surgery and radiotherapy delays improvement of mobility, radiotherapy-induced pain relief, local tumor control, and restart of systemic oncological therapy. Stereotactic body radiotherapy (SBRT) enables delivery of preoperative high-dose radiotherapy while dose-sparing the surgical field, allowing stabilizing surgery within only hours. Patients may experience earlier recovery of mobility, regression of pain, and return to systemic oncological therapy. The BLEND RCT evaluates the effectiveness of SBRT followed by surgery within 24 h for the treatment of symptomatic, unstable spinal metastases.

methodsThis phase III randomized controlled trial is embedded within the PRospective Evaluation of interventional StudiEs on boNe meTastases (PRESENT) cohort. Patients with symptomatic, unstable spinal metastases requiring stabilizing surgery and radiotherapy will be randomized (1:1). The intervention group (n = 50) will be offered same-day SBRT and surgery, which they can accept or refuse. According to the Trial within Cohorts (TwiCs) design, the control group (n = 50) will not be informed and receive standard treatment (surgery followed by conventional radiotherapy after 1-2 weeks when wound healing allows). Baseline characteristics and outcome measures will be captured within PRESENT. The primary outcome is physical functioning (EORTC-QLQ-C15-PAL) 4 weeks after start of treatment. Secondary endpoints include pain response, time until return to systemic oncological therapy, quality of life, local tumor control, and adverse events up to 3 months post-treatment. DISCUSSION: The BLEND RCT evaluates the effect of same-day SBRT and stabilizing surgery for the treatment of symptomatic, unstable spinal metastases compared with standard of care. We expect better functional outcomes, faster pain relief, and continuation of systemic oncological therapy. The TwiCs design enables efficient recruitment within an ongoing cohort, as well as prevention of disappointment bias and drop-out as control patients will not be informed about the trial.

trial registrationClinicalTrials.gov NCT05575323. Registered on October 11, 2022.

Indexed as

Pedicle ScrewsRadiosurgerySpinal NeoplasmsHospitalsHumansPainQuality of LifeCost-effectivenessRCTSame-day treatmentSBRTSpinal metastasesSurgeryTwiCs

Identifiers

PMID37143158
PMCPMC10157966
OpenAlexW4372335923

What OpenQuestion holds

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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.