Evidence map›Paper›PMID 41874739›Full record

ArticleJournal of neuro-oncology2026

Clinical outcomes of stereotactic body radiotherapy for spinal metastases with paraspinal extension.

D Ross, N Vuppala, M C LeCompte, M Khan, A Bydon, K Kebaish, N Theodore, B Wu, L R Kleinberg, S Hun Lee and 2 more

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Article in Journal of neuro-oncology, 2026. 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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0cells of the map it votes in
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

12 authors.

D RossJohns Hopkins Medicine Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, MD, USA.
N VuppalaJohns Hopkins Medicine Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, MD, USA.
M C LeCompteLevine Cancer Institute, Atrium Health, Charlotte, NC, USA.
M KhanJohns Hopkins Medicine Department of Radiology and Radiological Science Baltimore, Baltimore, MD, USA.
A BydonJohns Hopkins Medicine Department of Neurological Surgery Baltimore, Baltimore, MD, USA.
K KebaishJohns Hopkins Medicine Department of Orthopaedic Surgery Baltimore, Baltimore, MD, USA.
N TheodoreJohns Hopkins Medicine Department of Neurological Surgery Baltimore, Baltimore, MD, USA.
B WuJohns Hopkins Medicine Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, MD, USA.
L R KleinbergJohns Hopkins Medicine Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, MD, USA.
S Hun LeeJohns Hopkins Medicine Department of Orthopaedic Surgery Baltimore, Baltimore, MD, USA.
D LubelskiJohns Hopkins Medicine Department of Neurological Surgery Baltimore, Baltimore, MD, USA.
K J RedmondJohns Hopkins Medicine Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, MD, USA. kjanson3@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSBRT for spinal column metastases with paraspinal extension poses a challenge for local control. However, data is limited. The purpose of this study is to better characterize patterns of local recurrence in this patient population with the goal of improving outcomes.

methodsPatients with spinal metastases with paraspinal extension treated with SBRT at a single institution from 2009 to 2021 were reviewed. Sites with previous surgery and/or radiation were included. Univariate analysis of size, planning target volume (PTV) shape, previous fracture, multiple vertebral levels, muscle invasion, organ abutment, and dosimetric variables in relation to time-to-local failure (LF) was performed.

resultsSeventy-six paraspinal masses were included in the analysis. Median follow-up period was 11.8 months. Seventy-six percent of thoracic paraspinal extension involved adjacent ribs. Twenty-one percent of paraspinal extension abutted organs, 18% had muscle invasion. The most common prescription for both radiation naive and re-irradiation treatments was 2700 cGy in 3 fractions. The 12-month incidence of local failure (LF) was 30% overall and 29.4% for re-irradiated sites. Forty percent of LFs involved paraspinal extension. No analyzed variables were significantly associated with LF events, including PTV > 225cc and PTV shape (donut) (p = 0.08 and 0.07).

conclusionWhile clinical and dosimetric variables did not show significant associations with LF, a large portion of LF occurrences were observed within the paraspinal extension, suggesting that a generous asymmetrical expansion in the direction of paraspinal extension may help improve outcomes. This study emphasizes the importance of refining treatment approaches for this population.

Indexed as

Neoplasm Recurrence, LocalRadiosurgerySpinal NeoplasmsAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeAsymmetric CTVParaspinal extensionRe-irradiationSpine SBRT

Identifiers

PMID41874739

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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.