Definitive Radiation for High-Risk Spine Metastases

Inclusion Criteria11

• 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)