Stereotactic Body Radiotherapy (SBRT) for Pulmonary Metastases in Ewing Sarcoma, Rhabdomyosarcoma, and Wilms Tumors

Status: Recruiting
Phase: Phase 1/Phase 2
DFCI Protocol ID: 15-278

This research study is studying stereotactic body radiotherapy (SBRT) as a possible treatment for lung relapse of Ewing Sarcoma, Rhabdomyosarcoma, or Wilms Tumor. SBRT is a form of targeted radiotherapy that can treat very small tumors using a few large doses.

Conducting Institutions:

Dana-Farber Cancer Institute, Brigham and Women's Hospital, Children's Hospital Boston

Overall PI:

Karen Marcus, MD, Brigham and Women's Hospital

Site-responsible Investigators:


Brigham and Women's Hospital: Dana Apkon, 617-525-3156,

Eligibility Criteria

Inclusion Criteria:

  -  Diagnosis of Ewing sarcoma, rhabdomyosarcoma or Wilms tumor or other primary renal

  -  Age 8.0 to age 18.99 years

  -  Must be capable of treatment without general anesthesia

  -  Lesion size 8 mm - 3 cm

  -  Pulmonary metastases found at relapse (does not have to be first relapse); no more
     than 3 lesions per hemi-thorax

  -  Greater than 5 weeks from doxorubicin at the time of consent, with radiation to be
     initiated no less than 6 weeks from doxorubicin

  -  Greater than 3 weeks from intravenous chemotherapy except doxorubicin

  -  Informed consent/assent

  -  Life expectancy > 3 months

  -  Pulmonary function FEV1 ≥ 50% of predicted

  -  Females, minorities and other underrepresented populations that are at risk to
     develop Ewing sarcoma and the other included malignancies

Exclusion Criteria:

  -  Prior whole-lung or hemi-thorax irradiation of greater than or equal to 12 Gy (focal
     radiotherapy to the thorax is not an exclusion)

  -  Lesion larger than 3 cm in diameter

  -  Diffuse multiple (> 3 per lung) metastases

  -  Active or new metastatic disease outside of the lung

  -  Lesions within 2 cm of central structures defined as:

Tumor within or touching the zone of the proximal bronchial tree, defined as a volume 2 cm
in all directions around the proximal bronchial tree (carina, right and left main bronchi,
right and left upper lobe bronchi, intermedius bronchus, right middle lobe bronchus,
lingular bronchus, right and left lower lobe bronchi).

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