Solid Tumor, Adult
Conditions
Brief summary
A prospective study evaluating prone and supine positioning for radiation planning of spine Cyberknife radiotherapy treatment. Patients with tumours in which PTV coverage is compromised due to tumour geography, including posteriorly based lesions in the vertebral column and close proximity to organ at risk (other than the spinal cord).
Detailed description
This is a prospective, non-randomised radiotherapy planning study. Subsets of patients with specific tumour and anatomical characteristics will benefit from improved PTV prescription isodose coverage, reduced spinal cord dose, and organs at risk dose by undergoing either prone or supine setup, planning and treatment. Both prone and supine CT radiotherapy planning scans for patients undergoing spine SBRT treatment will undergo comparison of radiotherapy plans to guide recommendation of prone treatment for future patients. Patients continue to receive treatment in the proposed position as recommended y their treating physician.
Interventions
OTHERSetup and Imaging for at CT radiation planning
Patients will undergo an additional CT scan acquisition at CT radiotherapy planning in order that all participating patients have a prone and supine CT scan available to compare radiation therapy plans.
Sponsors
Royal Marsden NHS Foundation Trust
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* • Patients undergoing Cyberknife treatment to spinal metastasis * \>18 years of age * Thoracic, lumbar and sacral spinal metastasis * Patients suitable to undergo radiotherapy planning CT scans in the prone position (treating physician assessed as having spinal stability). * All solid tumour types will be eligible
Exclusion criteria
* • Primary spinal tumours * Vertebral disease resulting in unstable spinal vertebrae * Cervical tumours (patients will be unable to have a thermoplastic shell made for the prone position). * Patients with significant pain on prone lying (to be assessed by physician prior to consent) * Bilsky epidural score of 2 or greater (see appendix 1) * Pre-existing musculoskeletal chronic back medical diagnoses that would preclude CT scanning in the prone position.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PTV isodose coverage | Through study completion, an average of 1 year. | To compare the PTV coverage of radiotherapy plans delivered in prone and supine positions |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Organs at risk dose | Immediate | Compare organs at risk dose between supine and prone positioning. |
| Comfort scores | Immediate | Evaluate comfort scores in both treatment positions (supine and prone) |
| CT and MRI registration | Immediate | Evaluate CT and MRI registration on tumour target delineation |
| Treatment time duration | Immediate | Treatment time duration |
Countries
United Kingdom
Contacts
Primary ContactMerina Ahmed
Outcome results
None listed