ClinicalTrials.gg
Active, not recruitingNCT00508443Updated Oct 2, 2026

Evaluation of a Novel CT-On-Rails or Trilogy Stereotactic Spine Radiotherapy System (SSRS)

A Phase 1/2 interventional study of Radiation Therapy in Spinal Neoplasms, sponsored by M.D. Anderson Cancer Center. Active, not recruiting at 1 site in United States. Per ClinicalTrials.gov, last updated 2026-10-02.

Sponsored by M.D. Anderson Cancer Center · Phase 1/2, Interventional, and Treatment

From the registry’s dates

  • Registered 4 years 9 months after the study started (first participant enrolled Oct 2002, registered Jul 2007).
Updated Oct 2, 2026Primary completion movedStudy completion movedGo to Updates ↓
Phase
Phase 1/2
Study type
Interventional
Enrollment
150
Allocation
Not applicable
Sex
All
01

Study summary

The goal of this clinical research study is to find out if stereotactic spine radiotherapy is safe and effective in the treatment of metastatic spine tumors. The feasibility of this type of treatment will be studied as will any side effects related to the treatment. The precision and accuracy of the CT-on-rails will also be studied.

Read the detailed description

CT-On-Rails or Trilogy is a system that places the radiation treatment machine in the same room as the CT scanner so that the CT scanner can help deliver radiation more precisely.

You will have a MRI of the spine within 1 month of registration on this study. You will also fill out a health survey (5 minutes), a symptom inventory ( 5 minutes), and a Brief Pain Inventory (5 minutes) within 1 week of registration.

A pretreatment feasibility study will first be performed to determine the precision, accuracy, and reproducibility with which the target volume and critical normal structures (e.g. spinal cord) can be positioned relative to the radiation beams for spine tumors; this will consist of a CT scan.

Patients will have a CT-simulation. The simulation is like a CT scan where a special body frame is used to keep the patient from moving during scanning and later treatment.

You will be asked questions about your medical history and have a complete neurological exam during your first consultation. The neurological exam involves testing upper and lower motor strength, sensation to light touch, reflexes, mental exam, and way you walk. MRI of the spine must be performed within 1 month of registration. You will be asked to complete 3 questionnaires to evaluate your symptoms and pain. Each questionnaire will take around 5 minutes to complete, and should be completed within 1 month of being enrolled in the study.

All patients will be treated with radiation therapy that is guided by the CT-on-Rails or Trilogy procedure. Patients will receive a CT scan immediately before the treatment in the same room of the treatment using CT-On-Rails or Trilogy. There will be a total of 3 treatments over a period of 2 weeks.

Monitoring of side effects will be focused on neurological, gastrointestinal, musculoskeletal, and hematological systems. Every attempt will be made to have the patient complete the prescribed course of radiation to maximize the beneficial effect of treatment. However, if there is severe side effects, radiation treatment will be stopped and patients will be taken off study.

You will have follow up visits once a week during radiation treatment, scheduled on the same day as radiation. After treatment, you will have telephone, mail, or follow-ups per fax scheduled at 2 and 4 weeks,and 2 months post radiation. You will have follow up visits scheduled at 3, 6, 9, 12, 18, and 24 months, then every six months for the rest of your life. At all follow-up visits, you will be asked questions about your medical history, have a neurological exam, and neurologic function will be evaluated. Any pain medication you are taking will be noted. You will have an MRI of the spine at 3, 6, 9, 12,18, and 24 months, then once a year for the rest of your life. You will also be asked to complete 3 questionnaires to evaluate your symptoms and pain. Each questionnaire will take around 5 minutes to complete.

This is an investigational study. The CT-on-rails and Trilogy linear accelerator are FDA-approved medical devices and are commercially available, however, the way these two devices are being used is investigational. Up to 150 patients will take part in this study. All will be enrolled at M. D. Anderson.

02

Conditions studied

  • Spinal Neoplasms

Keywords

  • Stereotactic Spine Radiotherapy System
  • SSRS
  • CT-on-Rails
  • Metastatic Spine Disease
  • Spinal Neoplasms
  • Radiation Therapy
  • Trilogy
  • Cancer
  • Breast Cancer
  • Gastrointestinal Cancer
  • Genitourinary Disease
  • Lung Cancer
  • Lymphoma
  • Melanoma
  • Sarcoma
  • Spinal Cancer
03

In context

Spinal Neoplasms

18 studies on the registry are indexed under Spinal Neoplasms; 5 are open to participants now.

This study's planned enrollment of 150 is above the median of 71 across 11 interventional studies indexed under Spinal Neoplasms.

Browse Spinal Neoplasms studies →

Lead sponsor

M.D. Anderson Cancer Center is the lead sponsor of 3,047 studies on the registry; 578 are open to participants now.

Of its 612 completed or terminated interventional studies of FDA-regulated products, 409 (67%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Radiographically documented spine or paraspinal demonstrated on spine MRI within 4 wks of registration
  2. Maximum of 2 metastatic sites in the spine to be irradiated over a single course of treatment.
  3. for irradiation or re-irradiation of spinal or para-spinal tumor (s)
  4. Diagnosis cancer including but not limited to lung (non-small cell and small cell), breast, prostate, renal cell, melanoma, gastrointestinal, germ cell tumors, and unknown primary tumors
  5. performance status of at least 40 (i.e. not requiring active hospitalization)
  6. Maximum of 1 prior course of spine radiotherapy to the current region of interest allowed.

Exclusion criteria

Exclusion Criteria:

  1. Worsening neurological status due to radiographic evidence of spinal cord compression requiring immediate surgical decompression or emergent conventional external radiation therapy
  2. Delay in initiation of radiation treatment would be potentially detrimental to neurological outcome
  3. Patients already re-treated with radiation as part of this protocol will not be eligible for additional re-treatment
  4. Unstable spine requiring surgical stabilization.
  5. Sites outside the spine (eg. lung, liver) are not eligible for treatment
  6. Systemic radiotherapy (Sr-89) within 30 days
  7. Prior irradiation of the area to be treated within 3 months of registration
  8. Patients currently receiving, or who have received chemotherapy within 30 days are not eligible
  9. Inability to tolerate lying flat on treatment couch for greater than 30 minutes.
  10. Patient with multiple myeloma
  11. Patients unable to undergo MRI of the spine
  12. Patients with pacemakers
  13. Patients who have previously received maximum cord tolerance of 45 Gy in 5 weeks conventional fractionation or equivalent dose to the current area to be treated.
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
150 participants (estimated)

Study arms

  • Experimental
    Radiation Therapy

    Radiation Therapy using CT-on-Rails or Trilogy procedure. Participants prescribed to receive 9 Gy x 3 so that a peripheral dose of 27 Gy is given to the tumor.

    Radiation: Radiation Therapy

Interventions

  • RadiationRadiation Therapy

    Three radiation treatments guided by the CT-on-Rails or Trilogy procedure over a period of 2 weeks. Participants prescribed to receive 9 Gy x 3 so that a peripheral dose of 27 Gy is given to the tumor.

06

What researchers measure

Primary outcomes

  1. Patient Response (Pain Relief)

    The validated Brief Pain Inventory (BPI), MD Anderson Symptom Inventory (MDASI), and SF-12v2 Health Survey used to assess changes in these indicators compared to pre-treatment baseline. Response determined by follow-up questionaires. Time to maximal pain relief is the time from the first day of irradiation until the lowest pain score for average pain after radiotherapy. The "worst pain score" from BPI used as the marker for treatment success or failure.

    Time frame: Baseline, 3, 6, 9, 12, 18, and 24 months, then every six months

07

Study locations

1 site
08

References and documents

Publications

  • Wang XS, Rhines LD, Shiu AS, Yang JN, Selek U, Gning I, Liu P, Allen PK, Azeem SS, Brown PD, Sharp HJ, Weksberg DC, Cleeland CS, Chang EL. Stereotactic body radiation therapy for management of spinal metastases in patients without spinal cord compression: a phase 1-2 trial. Lancet Oncol. 2012 Apr;13(4):395-402. doi: 10.1016/S1470-2045(11)70384-9. Epub 2012 Jan 27. PubMed 22285199 ↗
  • Boehling NS, Grosshans DR, Allen PK, McAleer MF, Burton AW, Azeem S, Rhines LD, Chang EL. Vertebral compression fracture risk after stereotactic body radiotherapy for spinal metastases. J Neurosurg Spine. 2012 Apr;16(4):379-86. doi: 10.3171/2011.11.SPINE116. Epub 2012 Jan 6. PubMed 22225488 ↗
09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it moved

Started Oct 2002 (actual). Primary completion is estimated for Oct 2028, 312 months after the start.

Since we started tracking on Sep 25, 2026, the dates moved once, on Oct 2, 2026: primary completion Oct 2026 → Oct 2028 and completion Oct 2026 → Oct 2028.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Jul 27, 2007
First posted
Jul 30, 2007
StartActual
Oct 25, 2002
Primary completionEst.
Oct 31, 2028was Oct 2026
CompletionEst.
Oct 31, 2028was Oct 2026
Last update
Oct 2, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Primary completion
Oct 31, 2026→Oct 31, 2028
Oct 2, 2026
Study completion
Oct 31, 2026→Oct 31, 2028
Oct 2, 2026
Show all 1 update
  1. Oct 2, 2026
    Primary completion Oct 31, 2026→Oct 31, 2028
    Study completion Oct 31, 2026→Oct 31, 2028
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT00508443
Responsible party
Sponsor
First posted
Jul 30, 2007
Start date
Oct 25, 2002
Primary completion
Oct 31, 2028 (estimated)
Completion
Oct 31, 2028 (estimated)
Last update
Oct 2, 2026

Study contacts

Amol J. Ghia, MD
principal investigator · M.D. Anderson Cancer Center

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.

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