Radiation Therapy to Treat Musculoskeletal Tumors

Soft Tissue Sarcoma Clinical Trial

Official title: Image Guided Radiotherapy for the Treatment of Musculoskeletal Tumors: A Phase II Prospective Evaluation of Radiation-related Treatment Effects

Status Active, not recruiting

Clinical Trial Summary

Researchers at St. Jude Children's Research Hospital are looking for more effective ways to deliver radiation therapy to pediatric tumors of the bone and soft tissues. The goal of the study is to improve local control of musculoskeletal tumors with image-guided radiation therapy (IGRT) while minimizing radiation related side effects. IGRT uses computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) images to precisely define tumor location and to carefully plan radiation treatment. This approach allows doctors to deliver highly conformal radiation therapy to the tumor while protecting nearby healthy normal tissues.

Clinical Trial Description

The study focuses on the following primary Objectives:

• To estimate local control rates with image guided radiation therapy as defined in this study for patients with primary musculoskeletal tumors (MST).

• Prospectively establish a baseline estimate of local control for patients with MST (Ewing's sarcoma family of tumors (ESFT), rhabdomyosarcoma (RMS) and non-rhabdomyosarcoma soft tissue sarcoma (STS)) treated with image guided radiation therapy.

• Demonstrate that the increased level of conformality afforded by image guided radiation therapy does not reduce its efficacy relative to previously utilized non-image guided radiation therapy techniques in patients with Ewing's sarcoma family of tumors, resected soft tissue sarcomas, and group III rhabdomyosarcomas.

• Assess local and regional patterns of failure for patients with MST treated with image guided radiation therapy relative to their targeted volumes.

• Provide a long term (>5 year) estimate of local disease control for patients with MST (Ewing's sarcoma family of tumors (ESFT)), rhabdomyosarcoma (RMS), and non-rhabdomyosarcoma soft tissue sarcoma (STS) treated with image guided radiation therapy.

The study focuses on the following secondary objectives:

• Establish a quantitative baseline estimate of radiation dose-related changes in normal tissues using novel objective measures of somatic change, musculoskeletal function, tissue biochemistry and physiology.

o Investigate the dose and volume relationship for the developing physis and cortical bone using physical measures and imaging evaluations including:

• Prospectively investigate whether an age based radiotherapeutic threshold of dose and volume that will induce premature physis closure and alter long bone length can be quantitatively identified.

• Quantitatively explore the impact of radiation on cortical bone thinning and long bone curvature.

• Relate radiation dose and volume to late (10+ year) alterations in bone integrity.

• Describe the severity and time course of radiation-induced changes in the soft tissues including muscle.

• Delineate sequential changes in muscular volume, muscle function and organ function (delineated by imaging and measures of physical function) following image guided radiation for specific muscular groups.

• Correlate the temporal changes in muscular volume and function with changes in vascularity and metabolism defined by imaging studies. ;

Related Conditions & MeSH terms

• Musculoskeletal Tumors
• Neuroectodermal Tumors, Primitive, Peripheral
• Rhabdomyosarcoma
• Sarcoma
• Sarcoma, Ewing
• Sarcoma, Ewing's
• Soft Tissue Sarcoma

• NCT number: NCT00186992
• Study type: Interventional
• Source: St. Jude Children's Research Hospital
• Status: Active, not recruiting
• Phase: Phase 2
• Start date: January 10, 2003
• Completion date: October 2024