Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

335 questions · 340 findings · 46 reviews · Pain, Palliative and Supportive Care

No studies found 66 · 19.4%GRADE not reported 16 · 4.7%Very low 102 · 30%Low 68 · 20%Moderate 59 · 17.4%High 29 · 8.5%

Single‐fraction radiotherapy (8 Gy) vs short‐course radiotherapy (16 Gy

Ambulation · adults with metastatic extradural spinal cord compression (poor prognosis with visceral metastasis, and no spinal instability or bony…

Single‐fraction radiotherapy (8 Gy) showed no clear difference in ambulation One month after radiation compared with short‐course radiotherapy (16 Gy (moderate certainty).

1 finding from 1 review

Split‐course radiotherapy (8 fractions, 30 Gy) vs short‐course radiotherapy (16 Gy

Reduction in analgesic and narcotic use One month after radiation · adults with metastatic extradural spinal cord compression (poor prognosis, no spinal instability or bony impingement of cord)

Split‐course radiotherapy (8 fractions, 30 Gy) showed no clear difference in reduction in analgesic and narcotic use One month after radiation compared with short‐course radiotherapy (2 fractions, 16 Gy) (moderate certainty).

1 finding from 1 review

Split‐course radiotherapy (8 fractions, 30 Gy) vs short‐course radiotherapy (16 Gy

Urinary continence One month after radiation · adults with metastatic extradural spinal cord compression (poor prognosis, no spinal instability or bony impingement of cord)

Split‐course radiotherapy (8 fractions, 30 Gy) showed no clear difference in urinary continence One month after radiation compared with short‐course radiotherapy (2 fractions, 16 Gy) (moderate certainty).

1 finding from 1 review

Split‐course radiotherapy (8 fractions, 30 Gy) vs short‐course radiotherapy (16 Gy

Local recurrence · adults with metastatic extradural spinal cord compression (poor prognosis, no spinal instability or bony impingement of cord)

Split‐course radiotherapy (8 fractions, 30 Gy) showed no clear difference in local recurrence compared with short‐course radiotherapy (2 fractions, 16 Gy) (low certainty).

1 finding from 1 review

Split‐course radiotherapy (8 fractions, 30 Gy) vs short‐course radiotherapy (16 Gy

Adverse events Grade 3 oesophagitis, diarrhoea and nausea · adults with metastatic extradural spinal cord compression (poor prognosis, no spinal instability or bony impingement of cord)

Split‐course radiotherapy (8 fractions, 30 Gy) showed no clear difference in adverse events Grade 3 oesophagitis, diarrhoea, and nausea compared with short‐course radiotherapy (2 fractions, 16 Gy) (moderate certainty).

1 finding from 1 review

Laminectomy plus radiotherapy vs radiotherapy

Ambulation · adults with metastatic extradural spinal cord compression (single lesion, no prior radiotherapy, fit for surgery)

It is very uncertain whether laminectomy plus radiotherapy changes ambulation At four months compared with radiotherapy (very low certainty).

1 finding from 1 review

Laminectomy plus radiotherapy vs radiotherapy

Survival At four months · adults with metastatic extradural spinal cord compression (single lesion, no prior radiotherapy, fit for surgery)

It is very uncertain whether laminectomy plus radiotherapy changes survival At four months compared with radiotherapy (very low certainty).

1 finding from 1 review

Laminectomy plus radiotherapy vs radiotherapy

Reduced use of analgesics · adults with metastatic extradural spinal cord compression (single lesion, no prior radiotherapy, fit for surgery)

It is very uncertain whether laminectomy plus radiotherapy changes reduction in analgesic use compared with radiotherapy (very low certainty).

1 finding from 1 review

Laminectomy plus radiotherapy vs radiotherapy

Urinary continence One month after radiation · adults with metastatic extradural spinal cord compression (single lesion, no prior radiotherapy, fit for surgery)

It is very uncertain whether laminectomy plus radiotherapy changes urinary continence One month after treatment compared with radiotherapy (very low certainty).

1 finding from 1 review

High‐dose corticosteroids vs moderate‐dose or no corticosteroids

Ambulation · adults with metastatic extradural spinal cord compression (without peptic ulceration or infection; mixed prognosis)

High‐dose corticosteroids showed no clear difference in ambulation compared with moderate‐dose or no corticosteroids (low certainty).

1 finding from 1 review

Single‐fraction radiotherapy (8 Gy) vs short‐course radiotherapy (16 Gy

Reduction in analgesic and narcotic use One month after radiation · adults with metastatic extradural spinal cord compression (poor prognosis with visceral metastasis, and no spinal instability or bony…

Single‐fraction radiotherapy (8 Gy) showed no clear difference in reduction in analgesic and narcotic use One month after radiation compared with short‐course radiotherapy (16 Gy (moderate certainty).

1 finding from 1 review

High‐dose corticosteroids vs moderate‐dose or no corticosteroids

Survival (long term) Over two years · adults with metastatic extradural spinal cord compression (without peptic ulceration or infection; mixed prognosis)

High‐dose corticosteroids showed no clear difference in survival (long term) Over two years compared with moderate‐dose or no corticosteroids (low certainty).

1 finding from 1 review

High‐dose corticosteroids vs moderate‐dose or no corticosteroids

Pain reduction · adults with metastatic extradural spinal cord compression (without peptic ulceration or infection; mixed prognosis)

High‐dose corticosteroids showed no clear difference in pain reduction compared with moderate‐dose or no corticosteroids (low certainty).

1 finding from 1 review