Stereotactic Body Radiation Therapy and Vertebroplasty in Treating Patients With Localized Spinal Metastasis

You may be eligible if

• Eligibility:
• Inclusion:
• Patients must have localized spine metastasis (a solitary spine metastasis; two contiguous levels, or up to three separate single vertebral levels are permitted)
• Patients must have a VAS of ≥4 at any of the planned treatment sites
• Patient with epidural, spinal nerve, and/or cord compression on MRI may be included
• Histologic confirmation of cancer is required by biopsy, prior surgery, or re-biopsy
• Narcotic pain prescription and usage information must be available and documented
• Patients must sign study specific consent
• Above the age of 18
• For women of childbearing age a negative pregnancy test is required
• Patients considered for the retreatment arm, must not of had prior radiation to the proposed spinal site within a 3 month interval prior to treatment
• Zubrod score of 0-2
• Exclusion:
• Patients who have been non-ambulatory for more than 7 days
• Patients with compression fractures
• Spine instability requiring fixation
• Patients with paraspinal extension
• Patients with bony fragments
• Planned systemic treatment within one week after treatment.
• Absence of pathological diagnosis of cancer
• Chemotherapy within one week of treatment
• Patients with Multiple Myeloma, Lymphoma, or Plasmacytoma
• Patient suffered from unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months
• Patient had a transmural myocardial infarction within the last 6 months
• Patient has an acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration
• Patient has hepatic insufficiency resulting in clinical jaundice and/or coagulation defects
• PT is not within normal limits or planned and feasible to be corrected to normal limits prior to vertebroplasy
• PTT is not within normal limits or planned and feasible to be corrected to normal limits prior to vertebroplasy
• Platelet count is \< 50,000
• History of significant psychiatric illness
• Note: Vertebroplasty may not be possible for certain patients due to tumor location or safety. In such cases, patients will omit the vertebroplasty but receive all other protocol care and follow-up Visual Analog Scoring