{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T23:59:40Z","timestamp":1785542380232,"version":"3.56.0"},"reference-count":52,"publisher":"Wiley","issue":"14","license":[{"start":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T00:00:00Z","timestamp":1567641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In the treatment of spinal metastases, stereotactic body radiotherapy (SBRT) delivers precise, high\u2010dose radiation to the target region while sparing the spinal cord. A range of doses and fractions had been reported; however, the optimal prescribed scheme remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two reviewers performed independent literature searches of the PubMed, EMBASE, Cochrane Database, and Web of Science databases. Articles were divided into one to five fractions groups. The Methodological Index for Non\u2010randomized Studies (MINORS) was used to assess the quality of studies. Local control (LC) and overall survival (OS) were presented for the included studies and a pooled value was calculated by the weighted average.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 38 included studies comprised 3,754 patients with 4,731 lesions. The average 1\u2010year LCs for the one to five fractions were 92.7%, 84.6%, 86.8%, 82.6%, and 80.6%, respectively. The average 1\u2010year OS for the one to five fractions were 53.0%, 70.4%, 60.1%, 48%, and 80%, respectively. The 24\u00a0Gy\/single fraction scheme had a higher 1\u2010year LC (98.1%) than those of 24\u00a0Gy\/two fractions (85.4%), 27\u00a0Gy\/three fractions (84.9%), and 24\u00a0Gy\/three fractions (89.0%). The incidence of vertebral compression fracture was 10.3%, with 10.7% in the single\u2010fraction group and 10.1% in the multi\u2010fraction group. The incidence of radiation\u2010induced myelopathy was 0.19%; three and two patients were treated with single\u2010fraction and multi\u2010fraction SBRT, respectively. The incidence of radiculopathy was 0.30% and all but one patient were treated with multi\u2010fraction SBRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SBRT provided satisfactory efficacy and acceptable safety for spinal metastases. Single\u2010fraction SBRT demonstrated a higher local control rate than those of the other factions, especially the 24\u00a0Gy dose. The risk of vertebral compression fracture (VCF) was slightly higher in single\u2010fraction SBRT and more patients developed radiculopathy after multi\u2010fraction SBRT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.2546","type":"journal-article","created":{"date-parts":[[2019,9,6]],"date-time":"2019-09-06T05:04:55Z","timestamp":1567746295000},"page":"6176-6184","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Efficacy and safety of different fractions in stereotactic body radiotherapy for spinal metastases: A systematic review"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7320-0252","authenticated-orcid":false,"given":"Yining","family":"Gong","sequence":"first","affiliation":[{"name":"Department of Orthopedics Peking University Third Hospital Beijing 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