ClinicalTrials.gg
RecruitingNCT07538024REVOL-SPINEUpdated Apr 20, 2026

Pilot Randomized Study for Treatment Volume De-Escalation for Spinal Metastases With Stereotactic Body Radiation Therapy

An interventional study of Stereotactic Body Radiation Therapy (SBRT) in control arm and Stereotactic Body Radiation Therapy (SBRT) in experimental arm in Metastases to Bone, sponsored by IRCCS Sacro Cuore Don Calabria di Negrar. Recruiting at 1 site in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-20.

Sponsored by IRCCS Sacro Cuore Don Calabria di Negrar · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 5 months after the study started (first participant enrolled Nov 2025, registered Apr 2026).
  • Started Nov 2025; still recruiting 1 year later.
Phase
Not applicable
Study type
Interventional
Enrollment
100
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

A single centre, non-profit, randomised, unblinded pilot study on volume definition for spinal stereotactic body radiation therapy treatment.

Randomization will be 1:1 between two types of SBRT treatment for spinal metastases. The statistical unit will be the individual vertebral metastasis. Multiple metastases will be randomized and evaluated independently.

Read the detailed description

Patients with spinal oligometastases who will be evaluated for SBRT will have to sign informed consent before any study-related procedure. Afterwards, a simulation computed tomography (CT) will be performed, and the metastases will be randomized to:

  • Control arm: volume definition according to Cox contouring guidelines
  • Experimental arm: volume definition based on the pathological lesion at Magnetic Resonance Imaging (MRI).

The treatment will be delivered at the center in either three or five fractions.

The planned follow-up consists of routine visits and exams, as per common clinical practice, according to primary histology (including an MRI to evaluate response of the vertebral lesion treated) at 3 months, 6 months, and subsequently every 6 months until the 2-year follow-up period. During these visits, physicians will assess the adverse events and NRS (a unidimensional measure of pain intensity in adults, from 0 to 10, and the result will be compared to the baseline).

The gross tumor volume (GTV) will be defined by MRI and PET uptake, if available, and the simulation CT. The treatment volume will be delineated based on MRI coregistered with the planning CT. The MRI protocol will include T1, T2-weighted, and diffusion-weighted imaging (DWI) sequences. The Planning Target Volume (PTV) will be obtained by adding an isotropic margin of 2 mm from the GTV, avoiding the spinal canal.

The clinical target volume (CTV) will be defined by the vertebral region according to the Cox contouring guidelines, and the PTV will be obtained by adding an isotropic margin of 2 mm from the CTV, avoiding the spinal canal.

Radiotherapy dose:

According to the current guidelines, available fractionations are 30 Gy in 3 fractions or 35 Gy in 5 fractions.

Planning:

The plan evaluation ensures at least 95% of the prescribed dose to 95% of the PTV without exceeding 120% of the prescribed dose. A partial PTV uncovering will be accepted if necessary to preserve mandatory constraints to OARs, considering a minor deviation if 95% of the PTV receives 85% or more of the prescribed dose, and a major deviation if 95% of the PTV receives less than 85% of the prescribed dose. Any deviation will be recorded but will not impact the patient's participation in the study.

02

Conditions studied

  • Metastases to Bone

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03

In context

Neoplasm Metastasis

4,040 studies on the registry are indexed under Neoplasm Metastasis; 886 are open to participants now.

This study's planned enrollment of 100 is above the median of 50 across 3,268 interventional studies indexed under Neoplasm Metastasis.

Browse Neoplasm Metastasis studies →

Lead sponsor

IRCCS Sacro Cuore Don Calabria di Negrar is the lead sponsor of 38 studies on the registry; 22 are open to participants now.

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

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Who can participate

Ages eligible
18 Years and older
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

  • Patients affected by spinal eligible for SBRT
  • All histologies are allowed
  • Oligometastatic disease (maximum 5 metastases) in every setting (oligopersistent, oligorecurrent and oligoprogressive, according to ESTRO consensus)
  • Metastases treated with ablative intent
  • Both symptomatic and asymptomatic vertebral metastases
  • Spine Instability Neoplastic Score (SINS) score \< 7 [18]
  • Age > 18 years
  • > 12 months
  • PS 0-1
  • Vertebral pathological lesion on the diagnostic MRI
  • Single active lesion on the target vertebra
  • More lesions in different vertebrae can be simultaneously treated
  • to trial participation and personal data treatment

Exclusion criteria

Exclusion Criteria:

  • More than 2 adjoining vertebrae involved
  • Palliative intent
  • 2 or more lesions on the target vertebra
  • to MRI
  • More than 5
Terms in these criteria, in plain language(5)

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.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

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.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
100 participants (estimated)

Study arms

  • Active comparator
    Control Arm

    volume definition of SBRT according to Cox contouring guidelines \[Cox BW, International Spine Radiosurgery Consortium consensus guidelines for target volume definition in spinal stereotactic radiosurgery\]

    Radiation: Stereotactic Body Radiation Therapy (SBRT) in control arm

  • Experimental
    Experimental arm

    volume definition of SBRT based on the pathological lesion at MRI delivered in three or five fractions

    Radiation: Stereotactic Body Radiation Therapy (SBRT) in experimental arm

Interventions

  • RadiationStereotactic Body Radiation Therapy (SBRT) in control arm

    Stereotactic Body Radiation Therapy performed in vertebral metastases with volume definition according to Cox contouring guidelines. The treatment will be delivered at the participating center in either three or five fractions. The planned follow-up consists of routine visits and exams as per common clinical practice, according to primary histology (including an MRI to evaluate response of the vertebral lesion treated) at 3 months, 6 months, and subsequently every 6 months until the 2-year follow-up period. The definition of the CTV in the control arm will include the vertebral region according to Cox contouring guidelines and the PTV will be obtained by adding an isotropic margin of 2 mm from the CTV, avoiding the spinal canal.

  • RadiationStereotactic Body Radiation Therapy (SBRT) in experimental arm

    Stereotactic Body Radiation Therapy performed in vertebral metastases with volume definition based on the pathological lesion at MRI. The treatment will be delivered at the participating center in either three or five fractions. The planned follow-up consists of routine visits and exams as per common clinical practice, according to primary histology (including an MRI to evaluate response of the vertebral lesion treated) at 3 months, 6 months, and subsequently every 6 months until the 2-year follow-up period. Gross tumor volume (GTV) in the experimental arm will include the part of pathological uptake on MRI, after rigid co-registration with the simulation CT: the treatment volume will be delineated based on the diagnostic magnetic resonance imaging (MRI) coregistered with the planning computed tomography (CT) scan. The MRI protocol will include contrast-enhanced T1, T2-weighted, and diffusion-weighted imaging (DWI) sequences.

06

What researchers measure

Primary outcomes

  1. 2-years local progression-free survival

    Evaluation of the 2-years local progression-free survival (LPFS) of a different volume of SBRT for spinal treatment, targeted to the pathological lesion, evaluating the response after irradiation.

    Time frame: At 2 years from enrollment

Secondary outcomes

  1. Local progression-free survival at 3, 6, 12 and 18 months

    Evaluation of local progression-free survival at 3, 6, 12 and 18 months of a different volume of SBRT for spinal treatment, targeted to the pathological lesion, evaluating the response after irradiation

    Time frame: At 3, 6, 12 and 18 months from the enrollment

  2. Adverse events; progression on a new vertebral segment; pain relief and pseudoprogression

    Detection of: * adverse events related to the radiation treatment * progression on a new vertebral segment on the same vertebra, diagnosed on MRI * pain relief (\> 4 before the SBRT) * rate of pseudoprogression, defined as an increase of the lesion at MRI, not confirmed by subsequent examinations

    Time frame: At 3, 6, 12, 18 and 24 months from enrollment

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 20, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07538024
Lead sponsor
IRCCS Sacro Cuore Don Calabria di Negrar
Responsible party
Sponsor
First posted
Apr 20, 2026
Start date
Nov 4, 2025
Primary completion
May 4, 2029 (estimated)
Completion
May 4, 2029 (estimated)
Last update
Apr 20, 2026

Study contacts

Elvia Malo, Dr.
Contact
elvia.malo@sacrocuore.it
+39 0456014854

Oversight

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

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