Conformal High Dose Intensity Modulated Radiation Therapy for Asymptomatic Metastatic Disease to the Thoracic and Lumbar Spine
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 发起方
- 入组人数
- 14
- 试验地点
- 1
- 主要终点
- Time to Any Skeletal Related Event
研究概览
简要总结
The purpose of this study is to determine if Conformal High Dose Intensity Modulated Radiation Therapy is an appropriate option for treating cancer that has spread to the spinal column. This study involves patients who have been diagnosed with metastatic cancer to the thoracic and lumbar vertebral body levels and currently do not have symptoms caused from the area of concern. The goal is to prove that this is not only a safe form of treatment, but that Conformal High Dose Intensity Modulated Radiation Therapy can reduce the risk of cancer coming back in the area that the investigators treat which may reduce the risk of developing symptoms like pain in the future.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Histological confirmation of malignancy (non-small cell lung cancer, breast cancer (hormone refractory), prostate cancer (hormone refractory), lymphoma, renal cell carcinoma, myeloma by either biopsy or cytology of the primary or metastatic lesion.
- •Patients must have radiological documentation of metastatic disease to the thoracic or lumbar spine including both positron emitted tomography (PET) or nuclear medicine bone scan (NMBS) and Magnetic Resonance Imaging (MRI) within 4 weeks prior to study entry.
- •Patients with one to three spinal metastases to the thoracic or lumbar spine will be included.
- •Spinal metastatic lesions should be limited to one vertebral body level or ≤ 6cm in greatest dimension.
- •Tumors should not directly abut the spinal cord, and have at least 5mm separation from the spinal cord. For patients with tumors closer than 5mm, inclusion is permissible at the discretion of the treating radiation oncologist such that dosimetric review demonstrates that the total dose to spinal cord is within tolerable range of <10Gy to 10% partial volume or max point dose 18 Gy.
- •Patients must be able to fit into either the Elekta Stereotactic Body Frame or the Elekta Stereotactic BodyFix immobilization device.
- •Must be ≥ 18 years of age.
- •ECOG status 0-
- •Women of childbearing potential and male participants must use an effective contraception method. (Until at least 60 days following treatment.)
- •Negative urine pregnancy test within at least one week before starting treatment in women of child-bearing age.
- •Patients must sign a study-specific informed consent form.
排除标准
- •Patients with evidence of spinal instability OR neurologic deficit resulting from bony compression of neurologic structures.
- •Patients with other systemic illness, or have not recovered adequately from their primary treatment or who have evidence of progression of their current cancer prior to therapy that, in the investigator's opinion, would preclude their inclusion.
- •Patient may not receive concomitant cytotoxic anti-neoplastic therapy during treatment. Patients may be allowed to use hormonal suppression therapy or bisphosphonates for hypercalcemia.
- •Pregnant or lactating women.
- •Any patient with symptoms of pain, compression fracture, neurologic deficit will not be included.
- •Patients previously treated with radiation therapy to the thoracic or lumbar spinal levels of involved disease will not be included.
研究组 & 干预措施
Radiation Therapy to Local Spine Metastasis
Conformal High Dose Intensity Modulated Radiation Therapy to a single asymptomatic local spine metastasis.
干预措施: Conformal High Dose Intensity Modulated Radiation Therapy (Radiation)
结局指标
主要结局
Time to Any Skeletal Related Event
时间窗: up to 24 months
Time to any skeletal related event most commonly symptomatic recurrence or progression with pain/neurologic impairment with evidence of radiographic progression (median local progression-free survival).
次要结局
- Acute Radiation Toxicity(90 days)
- Late Radiation Toxicity(2 years)
研究者
Ronald McGarry
Professor, Radiation Medicine
University of Kentucky