Definitive Radiation for High-Risk Spine Metastases

Inclusion Criteria

• •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
• •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)