Evidence map›Paper›PMID 40670813›Full record

ArticleJournal of neuro-oncology2025

Prognostic factors for local failure and overall survival in patients with epidural disease at the cauda equina following stereotactic body radiotherapy: a clinical, anatomic and dosimetric analysis.

Sondos Zayed, Mark Ruschin, Eshetu G Atenafu, Hanbo Chen, Deepak Dinakaran, Jay Detsky, Sten Myrehaug, Hany Soliman, Christopher Witiw, Jeremie Larouche and 3 more

Abstract read
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Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

13 authors.

Sondos ZayedDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Mark RuschinDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Eshetu G AtenafuDepartment of Biostatistics, University Health Network, University of Toronto, Toronto, Canada.
Hanbo ChenDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Deepak DinakaranDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Jay DetskyDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Sten MyrehaugDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Hany SolimanDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Christopher WitiwDivision of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Jeremie LaroucheDivision of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Pejman MaralaniDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Arjun SahgalDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Chia-Lin TsengDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. chia-lin.tseng@sunnybrook.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe relationship between spine SBRT outcomes and the extent of epidural cauda equina compression (ECEC) by malignant epidural disease has yet to be reported. Our objective was to determine clinical, anatomic and dosimetric factors that predict for local failure (LF) and overall survival (OS) specific to ECEC.

methodsConsecutive patients with ECEC treated with spine SBRT were retrospectively reviewed. ECEC parameters including anatomic measurements, lumbar stenosis grading, anatomic disease position and various dosimetric factors, were analyzed for their prognostic utility. Covariates with a p-value ≤ 0.20 on univariate analysis were selected for multivariable analysis (MVA), and those statistically significant (p < 0.05) were included in the final model.

resultsNinety-four spinal segments (79 patients) with ECEC were identified, 69 (73%) were intact (non-operated) and 25 (27%) post-operative. MVA identified a significantly lower risk of LF with systemic-therapy prior to SBRT (HR 0.164, p = 0.0005), ECEC encompassing ≤ 1/3 of the circumference of the spinal canal (HR 0.216, p = 0.0194) and an epidural disease volume < 0.45cm

conclusionThe volume and circumferential extent of epidural disease within the spinal canal are important factors for LF in ECEC treated by SBRT, suggesting a possible therapeutic role for surgical cytoreduction to enable optimal treatment planning.

Indexed as

Cauda EquinaCauda Equina SyndromeEpidural NeoplasmsRadiosurgerySpinal NeoplasmsAdultAgedAged, 80 and overEpidural SpaceFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRadiotherapy DosageCauda equina compressionEpidural diseaseSpine metastases

Identifiers

PMID40670813

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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.