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Postoperative Edge (RapidArc) Stereotactic Body Radiotherapy for Spinal Metastases

30. august 2026 opdateret af: Tianjin Medical University Cancer Institute and Hospital

Prognostic Study of Postoperative Edge (RapidArc) Stereotactic Body Radiotherapy for Spinal Metastases From Solid Tumors

This study observes the effectiveness of high-precision radiation therapy using the Edge system after surgery for patients with spinal metastases. Spinal metastases can press on the spinal cord and cause pain, weakness, or paralysis. This treatment uses higher doses of radiation in fewer sessions (hypofractionated stereotactic body radiotherapy) delivered precisely by the Edge machine to target remaining tumor cells while protecting the spinal cord. The study aims to see if this approach improves local tumor control, improves neurological function, shortens treatment duration, and improves quality of life in these patients. The study is observational, meaning patients receive standard care, and data is collected to evaluate the outcomes.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a single-center, prospective, observational cohort study conducted at Tianjin Medical University Cancer Institute and Hospital to evaluate the clinical outcomes of postoperative Edge (RapidArc) Stereotactic Body Radiotherapy (SBRT) in patients with spinal metastases from solid tumors. A total of 50 patients with postoperative metastatic epidural spinal cord compression (MESCC) will be enrolled. The treatment protocol prescribes a total dose of 35 Gy in 5 fractions (7 Gy per fraction) delivered using the Edge system. The Edge system features sub-millimeter precision, six-dimensional dynamic positioning, and optical surface monitoring (OSMS), which allows for a steep dose gradient, high biological effective dose (BED), and maximal spinal cord protection. The study will evaluate local control rate (LC) and neurological improvement (Frankel score) at 3 months as the primary outcome. Secondary outcomes include 1-year and 2-year LC, neurological deterioration-free survival (NDFS), overall survival (OS), and quality of life (EORTC QLQ-C30). Adverse events including acute radiation myelitis and esophagitis will be monitored. Data will be analyzed using SPSS 27.0 and R 4.3.2, with survival curves generated via the Kaplan-Meier method and Cox regression models used for prognostic factor analysis.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

50

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Kina
    • Tianjin Municipality
      • Tianjin, Tianjin Municipality, Kina
        • Rekruttering
        • 300060
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Patients diagnosed with spinal metastases from solid tumors who underwent surgery and had residual metastatic epidural spinal cord compression (MESCC) requiring postoperative radiotherapy. All participants were enrolled at Tianjin Medical University Cancer Institute and Hospital.

Beskrivelse

Inclusion Criteria:

  1. Age 18 to 80 years, any sex.
  2. Karnofsky Performance Status (KPS) >= 60 or ECOG Performance Status <= 2.
  3. Confirmed spinal metastases from solid tumors by pathology or imaging (MRI/CT).
  4. Postoperative imaging confirming residual epidural spinal cord compression (MESCC) requiring adjuvant radiotherapy.
  5. Number of lesions <= 5, and maximum diameter of a single lesion <= 5 cm.
  6. Interval between surgery and radiotherapy <= 4 weeks.
  7. Signed informed consent and willingness to participate in the study.

Exclusion Criteria:

  1. Uncontrolled primary tumor (e.g., extensive metastasis or progressive disease).
  2. Concurrent brain metastases or other active malignancies.
  3. Pathological fracture or severe spinal instability requiring emergency surgical intervention.
  4. Prior cumulative spinal cord radiation dose exceeding the tolerance threshold (e.g., previous spinal cord Dmax >= 45 Gy).
  5. Contraindications to radiotherapy (e.g., severe cardiopulmonary dysfunction, coagulation disorders).
  6. Severe postoperative complications (e.g., infection, poor wound healing) requiring delayed radiotherapy.
  7. Incomplete or unreliable medical records from external hospitals.
  8. Pregnant or lactating women.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Edge SBRT Group
Participants received postoperative stereotactic body radiotherapy (SBRT) using the Edge system, prescribed as 35 Gy in 5 fractions (7 Gy per fraction).
Stråling: Stereotactic Body Radiotherapy
Postoperative stereotactic body radiotherapy using the Edge system, delivered as 35 Gy in 5 fractions (7 Gy per fraction).
Andre navne:
  • Edge System

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Local Control Rate (LC)
Tidsramme: 3 months post-treatment
Proportion of patients with local tumor control, assessed by MRI showing residual tumor volume changes at 3 months post-treatment.
3 months post-treatment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Neurological Deterioration-Free Survival (NDFS)
Tidsramme: 1 year and 2 years
Time from treatment initiation to neurological deterioration or death.
1 year and 2 years
Overall Survival (OS)
Tidsramme: 1 year and 2 years
Time from treatment initiation to death from any cause.
1 year and 2 years
Quality of Life (QoL)
Tidsramme: Baseline, 3 months, 1 year, and 2 years post-treatment
Change in quality of life scores assessed by the EORTC QLQ-C30 questionnaire.
Baseline, 3 months, 1 year, and 2 years post-treatment
Incidence of Adverse Events
Tidsramme: Up to 2 years post-treatment
Incidence of acute radiation myelitis, esophagitis, vertebral fractures, and skin reactions, graded according to CTCAE v5.0.
Up to 2 years post-treatment

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Tianjin Medical University Cancer Institute and Hospital

Efterforskere

  • Ledende efterforsker: Xu Liming, MD, Tianjin Medical University Cancer Institute and Hospital

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. juni 2025

Primær færdiggørelse (Anslået)

1. marts 2027

Studieafslutning (Anslået)

30. september 2028

Datoer for studieregistrering

Først indsendt

30. august 2026

Først indsendt, der opfyldte QC-kriterier

30. august 2026

Først opslået (Faktiske)

3. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

3. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

30. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • E20251145

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Individual participant data (IPD) will not be shared to protect patient confidentiality and adhere to institutional data protection policies.

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