Evidence map›Paper›PMID 39527381›Full record

ReviewJournal of neuro-oncology2025

A case series and review of stereotactic body radiation therapy for contiguous multilevel spine metastases.

Samuel Adida, Suchet Taori, Shovan Bhatia, Michael R Kann, Steven A Burton, John C Flickinger, Adam C Olson, Roberta K Sefcik, Pascal O Zinn, Peter C Gerszten

Erratum issuedAbstract readReview
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In one paragraph

Review in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Samuel AdidaSchool of Medicine, University of Pittsburgh Medical Center, 3550 Terrace St, Pittsburgh, PA, 15213, USA.
Suchet TaoriSchool of Medicine, University of Pittsburgh Medical Center, 3550 Terrace St, Pittsburgh, PA, 15213, USA.
Shovan BhatiaSchool of Medicine, University of Pittsburgh Medical Center, 3550 Terrace St, Pittsburgh, PA, 15213, USA.
Michael R KannSchool of Medicine, University of Pittsburgh Medical Center, 3550 Terrace St, Pittsburgh, PA, 15213, USA.
Steven A BurtonDepartment of Radiation Oncology, University of Pittsburgh Medical Center, 5115 Centre Ave, Pittsburgh, PA, 15232, USA.
John C FlickingerDepartment of Radiation Oncology, University of Pittsburgh Medical Center, 5115 Centre Ave, Pittsburgh, PA, 15232, USA.
Adam C OlsonDepartment of Radiation Oncology, University of Pittsburgh Medical Center, 5115 Centre Ave, Pittsburgh, PA, 15232, USA.
Roberta K SefcikDepartment of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, 29425, USA.
Pascal O ZinnDepartment of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop St Suite B-400, Pittsburgh, PA, 15213, USA.
Peter C GersztenDepartment of Radiation Oncology, University of Pittsburgh Medical Center, 5115 Centre Ave, Pittsburgh, PA, 15232, USA. gerspc@upmc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA majority of published series report on stereotactic body radiation therapy (SBRT) for 1-2 contiguous vertebral levels due to concerns regarding setup accuracy and radiation toxicity. This study evaluates patients with metastases spanning ≥ 3 contiguous levels treated with SBRT and augments its findings with a review of other studies investigating multilevel spine SBRT.

methodsAnalysis of a prospectively collected database of 49 patients with 55 metastases spanning ≥ 3 contiguous vertebral levels treated with SBRT at a single institution (2002-2023) was performed. Outcomes identified included local failure (LF), pain response, overall survival, and toxicity. The median single-fraction prescription dose was 15 Gy (range: 8-18); multifractionated treatment utilized prescription doses of 18-30 Gy in 2-5 fractions.

resultsMedian follow-up was 7 months (range: 1-103). The 6-month, 1-year, and 2-year cumulative incidence rates of LF were 7%, 11%, and 11%, respectively. No prognostic factors were associated with LF. Pain was reported to improve or remain stable for 49 lesions (89%). Ten adverse radiation events (18%) were identified; pain flare (5%), dermatitis (4%), and vertebral compression fracture (VCF, 9%). The 3-month, 6-month, and 1-year cumulative incidence rates of VCF were 4%, 7%, and 7%, respectively. No instances of esophageal toxicity or myelopathy were observed.

conclusionsThis study of multilevel SBRT is one of the largest to investigate outcomes in this challenging clinical scenario. Spine SBRT confers low rates of LF and toxicity for patients with multilevel disease, which was previously considered a relative contraindication. Spine SBRT may be considered in this patient population instead of low-dose palliative RT.

Indexed as

RadiosurgerySpinal NeoplasmsAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisProspective StudiesRetrospective StudiesContiguousLocal failureMultilevelRadiosurgerySBRTSpinal stereotactic radiosurgerySpine metastasisStereotactic body radiosurgeryTumor controlVertebral compression fracture

Identifiers

PMID39527381

What OpenQuestion holds

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Registered trials

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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.