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Active, not recruitingNCT03281889Updated Aug 7, 2026

Proton Craniospinal Irradiation With Bone Sparing to Decrease Growth Decrement From Radiation

An interventional study of Proton Beam in Brain Tumor, sponsored by Massachusetts General Hospital. Active, not recruiting at 2 sites in United States. Open to participants aged 3 Years to 18 Years. Per ClinicalTrials.gov, last updated 2026-08-07.

Sponsored by Massachusetts General Hospital · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
20
Allocation
Not applicable
Ages
3 Years to 18 Years
Sex
All
01

Study summary

This research study is studying proton radiation as a possible treatment for brain tumor that requires radiation.

The radiation involved in this study is:

-Proton Radiation

Read the detailed description

This research study is a Pilot Study to determine whether using proton therapy in participants that require craniospinal radiation (whole brain and spinal cord radiation therapy) with sparing of the bony spine will work. This is the first time investigators are examining bone sparing proton therapy in pediatric craniospinal radiation.

The FDA (the U.S. Food and Drug Administration) has not approved proton radiation for this specific disease but it has been approved for other uses.

In this research study, the investigators are studying proton radiation in participants that require craniospinal radiation. The standard of care for this procedure is photon radiation, which is very similar to proton radiation. The investigators believe that the precision of proton radiation may help to reduce the negative effects radiation has on the surrounding non-cancerous growing and developing tissue

02

Conditions studied

  • Brain Tumor

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Keywords

  • Brain Tumor
03

Who can participate

Ages eligible
3 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age ≥ 3 years and ≤ 18 years at the time of registration
  • Histologically proven malignancy necessitating cranio-spinal irradiation. This will include patients with a diagnosis of medulloblastoma, Supratentorial primitive neuroectodermal tumor (SPNET), germ cell tumor (GCT), disseminated ependymoma, embryonal tumor with abundant neuropil and true rosettes (ETANTR), Atypical Teratoid/Rhabdoid Tumor (ATRT), and disseminated low-grade glioma (LGG).
  • Life expectancy ≥ 12 months.
  • Signed informed consent document and assent when appropriate.
  • HGB of > 10 g/L and PLT count > 80 K/uL

Exclusion criteria

Exclusion Criteria:

  • Any prior therapeutic radiation therapy > 500 cGy has been delivered.
  • Individuals with a history of a different malignancy are ineligible except for the following circumstances: if they have been disease-free for at least 5 years and are deemed by the investigator to be a low-risk for recurrence of that malignancy; or, have had only cervical cancer in situ, or basal cell or squamous cell carcinoma of the skin.
  • Any major uncontrolled or poorly controlled intercurrent illness that would limit compliance with study requirements.
  • Pregnant females are excluded. Females of childbearing age/menstruating must confirm that either they are not sexually active or have a negative pregnancy test prior to initiation of radiation therapy.
  • Patients that receive concurrent chemotherapy with the exception of concurrent Vincristine.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
20 participants (actual)

Study arms

  • Experimental
    Proton Radiotherapy

    * Patients will be treated with Proton Beam once daily 5 days per week. * Doses will be prescribed such that maximum possible coverage is achieved

    Radiation: Proton Beam

Interventions

  • RadiationProton Beam

    precision radiation that reduce the negative effects radiation has on the surrounding non-cancerous growing and developing tissue

05

What researchers measure

Primary outcomes

  1. Feasibility of cranio-spinal irradiation (CSI) utilizing intensity-modulated proton therapy (IMPT) with pencil beam scanning (PBS) for vertebral body sparing (VBS) in pediatric patients.

    IMPT using PBS delivery will be considered to be feasible as a VBS technique for CSI in pediatric patients if the rate of grade 3/4 hematologic toxicity were no more than 5% within 3 months after the completion of radiation treatment, within the range associated with conventional techniques of CSI. Toxicity will be assess using Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0.

    Time frame: 3 months

Secondary outcomes

  1. Early marrow changes in the vertebral bodies

    Summary of early marrow changes in the vertebral bodies by Magnetic resonance imaging (MRI) of the spine during radiation therapy (RT) by comparing one study MRI to the baseline pre-RT MRI.

    Time frame: 2 years

  2. Vertebral column growth (measured by MRI) over 1 year

    Summary of vertebral column growth (measured by MRI) over 1 year following vertebral body sparing cranio-spinal irradiation in pediatric patients.

    Time frame: Last day of treatment to 1 year later

  3. Change in sitting height and standing height

    Summary of the changes in the participants sitting and standing heights.

    Time frame: Annually for 5 years

  4. Time to abnormality in spinal curvature

    Participants are monitored both clinically and by MRI for any abnormality in spinal curvature. The time to abnormality in spine curvature will be measured from the start of radiation to the date of documented abnormality or censored at the date of last follow-up for patients still alive with normal spine.

    Time frame: 5 years

  5. Disease Free Survival

    Disease-free survival is measured from the start of radiation to the date of progressive disease based on imaging studies obtained as standard care or to the date of death due to any cause, whichever is earlier. Disease-free survival will be estimated using the Kaplan-Meier method. Patients without progressive disease and still alive will be censored at their date of last contact.

    Time frame: 5 years

  6. Pattern of Disease Relapse

    Summary of the sites where the cancer relapses. Relapse is the regrowth of cancer cells.

    Time frame: 2 years

  7. Complete blood counts (CBC) over time

    Summary of the change in complete blood counts (CBC) over time as determined by yearly blood samples.

    Time frame: Annually for 5 years

  8. Change in levels of vitamin D, calcium, and growth hormones over time

    Summary of the changes in blood levels of vitamin D, calcium, and growth hormones.

    Time frame: Annually for 5 years

  9. Weight

    Summary of the changes in weight of the participants as assessed by yearly evaluations.

    Time frame: Annually for 5 years

  10. BMI

    Summary of the body mass index (BMI) of the participants as assessed by yearly physical evaluations.

    Time frame: Annually for 5 years

06

Study locations

2 sites
  • Massachusetts General Hospital
    Boston, Massachusetts 02214, United States
  • MD Anderson Cancer Center
    Houston, Texas 77030, United States
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References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03281889
Lead sponsor
Massachusetts General Hospital
Collaborators
National Cancer Institute (NCI)
Responsible party
Kevin X. Liu, MD, DPHIL (Principal Investigator, Massachusetts General Hospital) — Principal investigator
First posted
Sep 13, 2017
Start date
Jan 4, 2018
Primary completion
Jun 30, 2027 (estimated)
Completion
Dec 31, 2027 (estimated)
Last update
Aug 7, 2026

Study contacts

Shannon MacDonald, MD
principal investigator · Massachusetts General Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

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

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