2019
DOI: 10.1001/jama.2019.17913
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Effect of Single-Fraction vs Multifraction Radiotherapy on Ambulatory Status Among Patients With Spinal Canal Compression From Metastatic Cancer

Abstract: IMPORTANCE Malignant spinal canal compression, a major complication of metastatic cancer, is managed with radiotherapy to maintain mobility and relieve pain, although there is no standard radiotherapy regimen. OBJECTIVE To evaluate whether single-fraction radiotherapy is noninferior to 5 fractions of radiotherapy. DESIGN, SETTING, AND PARTICIPANTS Multicenter noninferiority randomized clinical trial conducted in 42 UK and 5 Australian radiotherapy centers. Eligible patients (n = 686) had metastatic cancer with… Show more

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Cited by 93 publications
(63 citation statements)
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“…Sadly audit data show that the regimen is underused however it should become the default during the pandemic [16] [17]. Recent trial data also reassures that this is an appropriate fractionation for those with malignant spinal cord compression [18].…”
Section: Palliative Treatmentsmentioning
confidence: 99%
“…Sadly audit data show that the regimen is underused however it should become the default during the pandemic [16] [17]. Recent trial data also reassures that this is an appropriate fractionation for those with malignant spinal cord compression [18].…”
Section: Palliative Treatmentsmentioning
confidence: 99%
“…For bony pain relief, a single 8 Gy fraction should be favored as equally effective as multiple fractions [ 58 ]. A single fraction also can be offered in case of metastatic cord compression [ 59 ]. The role of whole brain RT for the management of brain metastases remains controversial as medical treatments might already be beneficial with regard to symptom control [ 60 ].…”
Section: Radiotherapymentioning
confidence: 99%
“…For palliative radiotherapy, treatment courses should also be kept as short as possible for those who are frail. Reduction of regimes to single-fraction, where appropriate, for example in the management of bone metastases is preferable, known to be equally effective, compared to longer regimes [111][112][113]. Likewise, for patients with brain metastases, shorter regimes have similarly shown equivalence [114].…”
Section: Personalised Radiotherapy: the Role Of Frailty Assessmentmentioning
confidence: 99%