Dose Escalation of Hypofractionated Radiation Therapy in Patients With Metastatic Cancer

Inclusion Criteria

• •Histologically or cytologically confirmed diagnosis of cancer (including epithelial carcinoma, sarcoma, and melanoma)
• •Age 18 years and older
• •Life expectancy of \> 3 months
• •Patients with AJCC (6th edition, 2002) stage IV cancer with distant metastases and without pleural or pericardial effusion at diagnosis and before start of study
• •Patients with 1-5 sites of maximum tumor dimension (for each individual site) of ≤ 10 cm or \< 500 cc volume and amenable to radiation therapy as seen on standard imaging
• •Unidimensionally measurable disease (based on RECIST) is desirable but not strictly required
• •Brain metastases must have been treated prior to enrollment on study, preferably with stereotactic radiosurgery
• •ECOG performance status ≤ 2 or Karnofsky Performance Status ≥ 60%
• •No prior radiation therapy to currently involved tumor sites
• •Room air saturation \> 90%
• •Hemoglobin \> 9.0 g/dl
• •ANC \>=1,500/microliter
• •Platelets \>=100,000/microliter
• •Total bilirubin within institutional limits
• •Albumin \> 2.9 g/dl
• •Alkaline phosphatase \< 2.5x upper limit of normal
• •AST and ALT \< 2.5 x upper limit of normal
• •Ability to understand and willingness to sign a written informed consent document