Rapid Response MRI-Guided Palliative Radiotherapy for Urgent Treatment of Metastatic Spinal Cord Compression Compared to Standard Radiotherapy Pathway
Led by The Christie NHS Foundation Trust · Updated on 2025-12-02
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52 weeks
Total Duration
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What this Trial Is About
Researchers are evaluating whether the Magnetic Resonance Linear Accelerator (MRL) can speed up radiotherapy treatment for patients with Metastatic Spinal Cord Compression (MSCC). The study aims to see if treatment can be successfully delivered in a single one-hour appointment on the MRL compared to the standard care pathway requiring two separate visits: a planning CT scan and a radiotherapy appointment. The trial also explores whether treatment with the MRL can be given within 24 hours from the decision to treat and assesses patient satisfaction through questionnaires.
Participants will receive radiotherapy with a prescribed dose of 8 Gray in one treatment using a single posterior-anterior beam. One group will have this treatment delivered on the MRL in a single session without the need for a prior planning CT scan, while the comparison group will follow the standard care pathway involving a planning CT appointment before radiotherapy. The study includes an optional diversity questionnaire prior to treatment and a patient experience questionnaire completed on the day of treatment. Treatment timings and patient outcomes will be monitored up to 12 months after therapy.
Participants will be followed through clinical notes at 1, 3, 6, and 12 months after treatment to record their well-being and function. The study involves a recruitment period of two years with follow-up lasting one additional year. Data collected includes the timing from decision to treat to completion of therapy, patient consent times, and patient-reported experience. Participants are free to withdraw from the trial at any time without penalty.
CONDITIONS
Brief Title
To Determine Whether it is Feasible to Treat Patients Requiring Urgent Radiotherapy Diagnosed With Metastatic Cord Compression (MSCC) on the Magnetic Resonance Linear Accelerator (MRL) in a Single Appointment and Compare it to the Standard of Care Radiotherapy Pathway
Who Can Participate
Age: 18Years +
All Genders
Eligibility Criteria
You may qualify if you...
Confirmed diagnosis of Metastatic Spinal Cord Compression (MSCC)
Referred for an 8Gy single fraction radiotherapy treatment
18 years or older
Able to give informed consent in writing or verbally
Willing to complete a patient experience questionnaire
Willing to allow the research team to review clinical notes for up to one year following treatment
You will not qualify if you...
Unable to provide informed consent
Any significant clinical disorder or laboratory finding making participation undesirable
Unwilling to allow researchers access to clinical notes and diagnostic scans
Unwilling to complete an experience questionnaire
Cannot speak or understand English
Contraindications to MRI identified after MRI safety screening
Unable to tolerate MRI scanning
Uncontrolled or poorly controlled pain
MSCC located in the cervical spine
More than one vertebral level of compression
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Your Study Journey
Screening
Duration - 1 day
Participants are screened for eligibility to participate in the trial.
1 screening visit (in-person)
Treatment
Duration - Up to 7 days from consent to treatment completion
Participants receive radiotherapy treatment for metastatic spinal cord compression either using the MR Linac in a single appointment without a prior planning CT scan or the standard pathway with a planning CT followed by radiotherapy.
1 treatment visit (in-person), plus 1 planning CT visit for standard care participants
Follow-up
Duration - 12 months
Participants complete a patient experience questionnaire on the day of treatment and clinical outcomes are monitored from clinical notes up to 12 months after treatment.
Follow-up assessments at 1, 3, 6, and 12 months post-treatment
Development and psychometric testing of an instrument to measure the patient's experience of external radiotherapy: The Radiotherapy Experience Questionnaire (RTEQ).
Kristina Olausson, Annette Holst Hansson, Björn Zackrisson...