PREST trial eligibility criteria | |
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Inclusion criteria | Exclusion criteria |
• Patients diagnosed with spinal bone metastases from solid, uncomplicated tumor • Primary or secondary tumor histology related to the treatment lesion • Patients aged > 18 years • Obtained informed consent • ECOG 0–2 • Symptomatic patients at the treatment site (NRS ≥ 4) • Symptomatic patients at the treatment site (NRS 1–3) assuming opioid therapy ongoing for more than 3 days • Spine Instability Neoplastic Score (SINS) < 7 • Prognosis > 6 months according to Mizumoto Prognostic Score (i.e., classes A and B) • Spinal metastases verified at MRI, including the sites to be enrolled • No more than three non-contiguous spinal segments (e.g., separated by at least two metamers) involved in the study | • Unable to assign specific NRS for each CTV to be enrolled • Unable to express autonomous consent to therapies • Pregnancy • Patient in hospice or with prognosis < 6 months • Unavailability forecast for follow-up • Absence of MRI pre-treatment study • Unable to maintain the treatment position for SBRT • Previous radiotherapy at the same site or at the level of adjoining metameres (higher or lower than the one to be enrolled) • Previous radiometabolic therapy • Previous enrolment of the same patient for three irradiated lesions • Epidural compression of the spinal cord or of the cauda equina • Injuries affecting > 25% of the medullary canal and/or a distance < 5 mm from the medulla or from the cauda • Injuries with indication of surgical stabilization • Chemotherapy or target therapy within the previous 7 days and 7 days after SBRT |