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Not yet recruitingNCT07589361VBS-CSI-PT-PEDUpdated May 15, 2026

Safety and Efficacy of Vertebral Body-Sparing Craniospinal Irradiation With Proton Therapy in Pediatric Tumors

An observational study in Pediatric Central Nervous System Tumors, Medulloblastoma and Germinoma, sponsored by Ruijin Hospital. Not yet recruiting. Open to participants aged 4 Years to 18 Years. Per ClinicalTrials.gov, last updated 2026-05-15.

Sponsored by Ruijin Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
38
Ages
4 Years to 18 Years
Sex
All
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Study summary

his is a single-center, prospective observational study in children and adolescents with central nervous system tumors who need whole-brain and whole-spine radiation therapy (craniospinal irradiation, CSI). The study uses proton therapy with a special vertebral body-sparing (VBS) technique to protect the front and center of the vertebrae, which helps preserve bone marrow function and growth. The main goals are to find safe dose limits for the vertebrae and check how often severe side effects occur. The study will also look at bone marrow preservation, spinal deformity, tumor control, survival, chemotherapy completion, neurocognitive function, quality of life, and growth and development for up to 5 years after treatment.

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Conditions studied

  • Pediatric Central Nervous System Tumors
  • Medulloblastoma
  • Germinoma
  • Ependymoma
  • Atypical Teratoid/Rhabdoid Tumor (AT/RT)
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In context

Medulloblastoma

317 studies on the registry are indexed under Medulloblastoma; 51 are open to participants now.

This study's planned enrollment of 38 is below the median of 163 across 34 observational studies indexed under Medulloblastoma.

Browse Medulloblastoma studies →

Lead sponsor

Ruijin Hospital is the lead sponsor of 679 studies on the registry; 387 are open to participants now.

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

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Who can participate

Ages eligible
4 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

This is a prospective observational study enrolling 38 pediatric patients aged >3 years and ≤18 years with histologically confirmed central nervous system tumors requiring craniospinal irradiation (CSI). Patients will be assigned to 2 cohorts: low-dose CSI and high-dose CSI. All participants will receive vertebral body-sparing intensity-modulated proton therapy (IMPT) and standard chemotherapy according to clinical guidelines.

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

  • The patient's legal guardian voluntarily signs the written form.
  • Age at diagnosis > 3 years and ≤ 18 years.
  • Histopathologically confirmed diagnosis of a central nervous system (CNS) tumor.
  • Indication for craniospinal irradiation (CSI) confirmed by multidisciplinary team (MDT) discussion.
  • Performance Score (KPS) ≥ 80.
  • For postoperative patients, complete healing of the surgical incision with no evidence of wound infection or other complications.
  • For women of , effective must be used for at least one month prior to screening, and they must commit to continued contraception throughout the study period and for the required time after study completion.

Exclusion criteria

Exclusion Criteria:

  • Previous receipt of any form of spinal radiotherapy.
  • Previous major spinal surgery for any reason.
  • Presence of and confirmed spinal deformity at enrollment (e.g., Cobb angle > 10° measured by MRI or X-ray).
  • Presence of medical to proton radiotherapy.
  • Presence of any severe, uncontrolled systemic disease (e.g., active infection, severe cardiac, hepatic, renal, or respiratory insufficiency) that, in the investigator's judgment, makes the subject unsuitable for treatment under this protocol.
  • Female patients who are pregnant or breastfeeding.
  • Presence of any severe cognitive or psychiatric disorder that prevents understanding of or cooperation with study assessments.
Terms in these criteria, in plain language(6)

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.

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.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

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.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
38 participants (estimated)
Patient registry
No

Groups and cohorts

  • Low-Dose Cohort

    Patients in the low-dose cohort receive vertebral body-sparing craniospinal irradiation (VBS-CSI) using pencil-beam scanning proton therapy at a prescription dose of 23.4 Gy(RBE) in 13 fractions or 24 Gy(RBE) in 15 fractions.

    Radiation: Vertebral Body-Sparing Craniospinal Proton Irradiation

  • High-Dose Cohort

    Patients in the high-dose cohort receive vertebral body-sparing craniospinal irradiation (VBS-CSI) using pencil-beam scanning proton therapy at a prescription dose of 36 Gy(RBE) in 20 fractions.

    Radiation: Vertebral Body-Sparing Craniospinal Proton Irradiation

Interventions

  • RadiationVertebral Body-Sparing Craniospinal Proton Irradiation

    Vertebral body-sparing craniospinal irradiation (VBS-CSI) using intensity-modulated proton therapy (IMPT, pencil-beam scanning). The treatment actively restricts radiation dose to the anterior and central regions of thoracolumbar vertebral bodies to preserve active bone marrow and spinal growth potential, while ensuring adequate target coverage for the whole brain and spinal cord. Two dose levels are applied: 23.4 Gy(RBE)/13 fractions or 24 Gy(RBE)/15 fractions and 36 Gy(RBE)/20 fractions.

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What researchers measure

Primary outcomes

  1. Incidence of ≥ Grade 3 acute adverse events

    To evaluate the incidence of treatment-related acute adverse events of grade 3 or higher, assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0).

    Time frame: Up to 3 months after completion of radiotherapy

Secondary outcomes

  1. Active Bone Marrow Preservation Rate

    The proportion of active bone marrow in the vertebral body is calculated by dividing the width of the low-signal area by the total diameter of the vertebral body, which allows a relatively quantitative assessment of the active bone marrow preservation rate.

    Time frame: Baseline, 3, 6, 12, 24, 36, 48, 60 months

  2. Incidence of spinal deformity

    Evaluation is performed using whole-neuraxis MRI or whole-spine anteroposterior and lateral X-ray films. Spinal scoliosis is quantitatively assessed using the Cobb angle measurement method by a radiologist who is blinded to the patient's specific treatment information. The degree of kyphosis is evaluated by assessing the presence of thoracic kyphosis. Additionally, vertebral body change characteristics of the thoracolumbar spine are measured, including the posterior-to-anterior ratio (PARs) of the vertebral body-defined as the ratio of the posterior vertebral body height to the anterior vertebral body height-as well as intervertebral disc height.

    Time frame: Baseline and at 6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months after treatment completion

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Study locations

No study locations are listed for this record.

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References and documents

Individual participant data

Plan to share: No

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 May 15, 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
NCT07589361
Lead sponsor
Ruijin Hospital
Responsible party
JIAYI CHEN (Director, Department of Radiation Oncology, Ruijin Hospital) — Principal investigator
First posted
May 15, 2026
Start date
Apr 30, 2026 (estimated)
Primary completion
Jun 30, 2029 (estimated)
Completion
Dec 31, 2033 (estimated)
Last update
May 15, 2026

Study contacts

Jiayi Chen
Contact
cjy11756@rjh.com.cn
+86 021 64370045

Oversight

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

Not currently enrolling

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

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