A Pilot Study of Proton Stereotactic Body Radiotherapy for Spinal Metastasis
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Summary
This is a single-arm pilot study of proton stereotactic body radiotherapy (SBRT) for nonhematologic spinal metastasis in patients with complex lesions that are unable to be effectively treated with standard of care photon SBRT defined as inability to develop a photon SBRT plan that achieves adequate coverage (≥80% planning treatment volume (PTV) coverage)) with a prescription dose of 30 Gy in 5 fractions.
Description
Spine metastases are common with a prevalence of up to 30-50% among patients with a cancer diagnosis. As cancer survivorship improves, durable local control is essential to decrease the risk of pain and neurologic deficits that are associated with spinal metastasis. SBRT for these tumors has demonstrated overall local control rates of approximately 80-90% in the largest published series. Emerging data highlight the importance of dose escalation for local control in SBRT for spinal metastases. The spinal cord is often the dose limiting structure in patients with spinal metastasis; however, ach…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Histologic proof or unequivocal cytologic proof of nonhematologic malignancy. This may be obtained from either the primary or any metastatic site. 2. Participants must have radiographic evidence of spinal metastasis on MRI. 3. Participants must have a complex case that is unable to be effectively treated with photon SBRT, defined as inability to develop a photon SBRT plan that achieves adequate coverage (≥80% PTV coverage) with a prescription dose of 30 Gy in 5 fractions. Such cases include: 1. Extensive paraspinal disease 2. Reirradiation setting 3. Epidural…
Interventions
- RadiationSpinal Proton SBRT
Patients will be treated with spinal proton SBRT over 5 fractions, with a prescription dose of 6 Gray equivalent (GyE) per fraction to the planning target volume.
Location
- Johns Hopkins HospitalBaltimore, Maryland