Long-Term Results of a Propensity Score Analysis Comparing 5 × 5 Gy and 10 × 3 Gy of Radiotherapy Alone for Malignant Spinal Cord Compression
Bibliographic record
Abstract
Background/Objectives: For many patients with malignant spinal cord compression (MSCC) not suitable for surgery, irradiation alone is the preferred treatment. A dose-fractionation regimen of 10 × 3 Gy is common for this situation. Since most patients suffer from motor deficits and pain, the number of radiotherapy sessions should be as low as possible. A secondary analysis of a phase 2 trial compared 5 × 5 Gy to a historical control group treated with 10 × 3 Gy. After 1:2 matching, 5 × 5 Gy appeared similarly effective regarding local progression-free survival (LPFS) at 6 months, motor function, walking ability, and overall survival. Methods: This retrospective study investigated whether these findings are consistent in a larger cohort and after longer follow-up. Additional data were gathered for the phase 2 cohort, follow-up in the control group was not limited to 6 months, and the number of patients in the control group increased from 213 to 728. Results: After propensity-score matching, no significant differences were found regarding LPFS after 12 (p = 0.198), 18 (p = 0.139), and 24 (p = 0.117) months, effect on motor function (p = 0.393), walking ability (p = 0.079), 24-month local control (p = 0.655), and 24-month OS (p = 0.403). Conclusions: Given the limitations of this study, 5 × 5 Gy appears preferable to 10 × 3 Gy in selected patients receiving irradiation without upfront surgery. Clinicians should balance initial convenience for the patients and future limitations when re-irradiation in the same part of the spine is required.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".