Definitive Radiation for High-Risk Spine Metastases

A Phase II Study Evaluating Definitive Radiosurgical Decompression in Patients With High-Risk Spinal Metastases

This study is looking at whether patients with cancer that has aggressively spread to the spine can be treated with stereotactic body radiation therapy only and avoid a large spine surgery

Eligible patients must have:

• Any pathologically proven solid tumor diagnosis not of central nervous system origin with radiographic or pathologic evidence of metastatic disease
• Metastatic spine involvement documented by imaging
• Involvement of maximum 3 contiguous vertebral bodies at the index site
• Intact neurologic function, or only minor neurologic deficits with muscle strength greater or equal to 4 out of 5 with or without steroids
• An evaluation by an radiation oncology and orthopedic spine/neurosurgery attending
• ECOG Performance Status of 0-3

Patients are ineligible if they have:

• An unstable spine defined as a Spinal Instability Neoplastic Score (SINS) greater than 12
• Had previous surgery or radiation to address the target spinal metastases
• Radiosensitive tumors (e.g. small cell lung cancer, lymphoma, multiple myeloma, and germ-cell tumors)