Study of Personalized Biomarkers During Pre-Surgery Radiation Therapy for Spinal and Sacral Chordoma

What this Trial Is About

Researchers are exploring the effects of neoadjuvant radiation therapy RT, specifically proton therapy or stereotactic body radiation therapy SBRT, on circulating tumor DNA ctDNA and imaging biomarkers in patients with chordoma of the spine, sacrum, or skull base. The study aims to determine if combining ctDNA levels with radiomic imaging features can accurately predict the tumors histopathologic response to RT. This approach is compared against the current gold standard of pathologic findings to improve diagnostic understanding of radiographic changes after treatment. Participants will undergo neoadjuvant RT using either proton therapy or SBRT before planned surgical removal of the tumor. The study collects data on ctDNA and radiographic changes during this period. Tumor response will be assessed by analyzing tissue obtained during surgery, and imaging features will be correlated with genomic and histopathologic data. This observational study tracks these biomarkers to evaluate their sensitivity and specificity within one week after surgery. During the study, participants will have blood samples taken to measure ctDNA levels and undergo imaging scans to collect radiomic data. Researchers will assess tumor cell activity, wound healing, quality of life, and long-term outcomes such as local progression-free survival and overall survival over a three-year period. Safety and treatment toxicity are also monitored. The total participation includes pre-treatment observation, treatment, surgery, and follow-up evaluations extending up to three years.

Exploration of Personalized Biomarkers During Neoadjuvant Radiation Therapy for Spinal and Sacral Chordoma