Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

145 questions · 157 findings · 13 reviews · Pain, Palliative and Supportive Care

No studies found 46 · 29.3%GRADE not reported 11 · 7%Very low 43 · 27.4%Low 39 · 24.8%Moderate 14 · 8.9%High 4 · 2.5%

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

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

Urinary continence 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 urinary continence One month after radiation compared with short‐course radiotherapy (16 Gy (moderate certainty).

1 finding from 1 review

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

Local recurrence · 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 local recurrence MRI: compared with short‐course radiotherapy (16 Gy (low certainty).

1 finding from 1 review

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

Adverse events Grade 3 oesophagitis, diarrhoea and nausea · 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 adverse events Grade 3 oesophagitis, diarrhoea and nausea compared with short‐course radiotherapy (16 Gy (moderate certainty).

1 finding from 1 review

Decompressive surgery plus radiotherapy vs radiotherapy

Ambulation · adults with metastatic extradural spinal cord compression (fit for surgery, paraplegic less than 48 hours, and without multiple discrete…

Decompressive surgery plus radiotherapy may leads to higher ambulation Immediately after completing RT compared with radiotherapy (low certainty).

1 finding from 1 review

Decompressive surgery plus radiotherapy vs radiotherapy

Survival (short term) At 30 days · adults with metastatic extradural spinal cord compression (fit for surgery, paraplegic less than 48 hours, and without multiple discrete…

Decompressive surgery plus radiotherapy showed no clear difference in survival (short term) At 30 days compared with radiotherapy (low 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