Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,655 questions · 1,751 findings · 147 reviews · Pain, Palliative and Supportive Care

No studies found 361 · 20.6%GRADE not reported 87 · 5%Very low 625 · 35.7%Low 367 · 21%Moderate 232 · 13.2%High 79 · 4.5%

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

High‐dose corticosteroids vs moderate‐dose or no corticosteroids

Urinary continence One week after treatment · adults with metastatic extradural spinal cord compression (without peptic ulceration or infection; mixed prognosis)

High‐dose corticosteroids showed no clear difference in urinary continence One week after treatment compared with moderate‐dose or no corticosteroids (low certainty).

1 finding from 1 review

High‐dose corticosteroids vs moderate‐dose or no corticosteroids

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

High‐dose corticosteroids probably leads to higher serious adverse events compared with moderate‐dose or no corticosteroids (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

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

Ambulation · 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 ambulation One month after treatment compared with short‐course radiotherapy (2 fractions, 16 Gy) (moderate certainty).

1 finding from 1 review