Evidence map›Paper›PMID 39492935›Full record

ArticleOncology letters2025

Role of epidural disease in local control of spinal metastases treated with stereotactic body radiation therapy.

Joseph R Linzey, Michael J Strong, Varun G Kathawate, Peyton E Goethe, Lila R Tudrick, Johan Lee, Arushi Tripathy, Sravanthi Koduri, Ayobami L Ward, Oludotun Ogunsola and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Oncology letters, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

15 authors.

Joseph R LinzeyDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.
Michael J StrongDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.
Varun G KathawateDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.
Peyton E GoetheDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.
Lila R TudrickDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.
Johan LeeUniversity of Michigan Medical School, University of Michigan Hospital, Ann Arbor, MI 48109, USA.
Arushi TripathyDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.
Sravanthi KoduriDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.
Ayobami L WardDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.
Oludotun OgunsolaDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.
Mark M ZakiDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.
Rushikesh S JoshiDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.
Joseph R EvansDepartment of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109, USA.
William C JacksonDepartment of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109, USA.
Nicholas J SzerlipDepartment of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Spinal metastases can be contained in the bone or have epidural spread. Whether the extent of epidural involvement changes tumor response to therapy is unknown. The decision of when to treat disease progression with focal radiation therapy with or without surgery vs. systemic therapy is debated. The present study compared outcomes and local tumor control after stereotactic body radiation therapy (SBRT) between patients with spine metastases localized to the bone (Bilsky 0) vs. patients with mild epidural spread (Bilsky 1). A retrospective analysis of a prospectively maintained database of adult oncological patients who underwent SBRT to the spine at a single, large, tertiary care facility from August 2010 to January 2021 was performed. Patients with Bilsky grades 1a, 1b and 1c were grouped and compared. Approximately half (53.7%) of the 255 patients identified had Bilsky grade 1 epidural disease. Of the 311 spine treatment sites, 86 (27.7%) had a radiosensitive histology, 116 (37.3%) had intermediate radiosensitivity and 109 (35.0%) had a radioresistant histology. Patients with Bilsky grade 1 were more predisposed to receive surgery followed by SBRT compared with those with Bilsky grade 0 (21.0% vs. 6.3%; P=0.0002). Patients with Bilsky grade 0 compression had 92.0% local control at 12 months and 85.8% local control at 24 months; patients with Bilsky grade 1 compression had 85.6% local control at 12 months and 77.6% local control at 24 months. Biologically effective dose and infield progression between patients presenting with Bilsky grade 0 and 1 compression were not statistically different. Local control rates did not differ significantly between Bilsky grade 0 and grade 1 patients following treatment with spinal SBRT. However, patients with grade 1 disease were more likely to receive surgery before SBRT. Overall, evidence indicates that patients may benefit from treatment with SBRT before epidural disease progresses to requiring separation surgery.

Indexed as

Bilsky gradelocal tumor controloutcomesspinal cordspinal epidural diseasestereotactic body radiation therapy

Identifiers

PMID39492935
PMCPMC11526205

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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.