Study Using High-Dose Single Fraction Image-Guided Radiotherapy for Metastatic Lesions to Soft Tissue Masses, Lymph Node, or Bone

Phase 1

Completed

Brief Summary: The purpose of this research study is to find out what IG-IMRT radiation dose works best for treatment of disease in bone or soft tissues. This protocol will study what dose level may work most effectively. The first part of study will treat 10 patients with 22 Gray. Gray (Gy) is the unit that is used to describe the dose of radiation that is being given to a person with cancer. After we confirm that 22 Gy is a safe and sufficient amount of radiation, we will then treat another group of patients with 24 Gy and so on until we reach 28 Gy. Each dose level starting with 24 Gy will enroll at least 20 patients per treatment site (bone, bowel and/or spine). Patients will be enrolled in each treatment category until 20 patients in each strata reach an evaluable time point of 3 months post-RT. When we understand what dose works best and has the least amount of bad effects, the study will then look to see how well the patients do after the radiation therapy. This study is trying to see how your doctor can best treat the cancer that has spread to the other parts of your body.

Recruitment & Eligibility

Inclusion Criteria

Biopsy-proven cancer verified at MSKCC
Imaging evidence of lymph node metastases, bone metastases or soft tissue disease
Age > or = to 18 years
KPS > or = to 80
Epidural disease is acceptable as long as the dose to the spinal cord ≤ 14 Gy
Able to tolerate immobilization cradle positioning

Exclusion Criteria

Target lesion not visible on conventional CT scan
Unable to be administered intravenous CT contrast safely
Prior radiation to the planned target region. A second metastatic lesion would not be eligible if the area received or will receive any dose (5% or greater isodose line)from a prior or planned single fraction treatment
Patients receiving concurrent chemotherapy (within 1 week of RT)
Normal tissue directly overlying target precluding ability to limit the bowel, bladder, rectum or other tissue to 15-16 Gy dose constraints
Weight-bearing bones with significant cortical destruction from tumor. In these cases, patients will be referred for orthopedic consultation for rod stabilization procedures.
Subjects with more than 4 metastases to bone
Any metastatic lesion larger than 8 cm in its greatest diameter

Arm && Interventions

Group	Intervention	Description
2	intensity modulated radiation therapy	Patients with metastatic disease to lymph nodes.
1	intensity modulated radiation therapy	Patients with metastatic disease to soft tissue.
3	intensity modulated radiation therapy	Patients with metastatic disease to the bone.

Primary Outcome Measures

Name	Time	Method
To assess the feasibility of single dose image-guided intensity modulated radiotherapy (IGIMRT)for metastatic disease to soft tissue, lymph nodes or bones.	conclusion of the study

Secondary Outcome Measures

Name	Time	Method
To obtain information on the effect of high-dose external beam irradiation on the biodistribution and pharmacokinetics of FLT.	2 years
To establish the maximal safe single fraction dose for osseous and soft tissue metastatic lesions using IG-IMRT in a Phase I dose escalation study.	conclusion of the study
To obtain preliminary information on the changes in tumor perfusion resulting from high-dose, single fraction IGRT for patients treated with approach to focal metastases using dynamic contrast-enhanced (DCE)-MRI.	2 years

Locations (1): Memorial Sloan Kettering Cancer Center
🇺🇸
New York, New York, United States

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