One-stop MR-guided radiotherapy for urgent metastatic spinal cord compression
Rapid Response MRI-Guided Palliative Radiotherapy
This study will test whether an MR linear accelerator can deliver urgent single-appointment radiotherapy for people with metastatic spinal cord compression so they do not need a separate planning CT.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 72 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | The Christie NHS Foundation Trust Academic / other |
| Locations | 1 site (Manchester) |
| Trial ID | NCT06965101 on ClinicalTrials.gov |
What this trial studies
Patients with confirmed metastatic spinal cord compression referred for a single 8 Gy palliative dose will be treated on an MR linear accelerator in a single appointment using an online scan-plan-and-treat workflow, and compared to a group receiving standard care with a separate planning CT and treatment visit. The trial measures feasibility, time from decision-to-treat to treatment delivery (including whether treatment can occur within 24 hours), and patient-reported experience. The protocol includes MR-based planning adjustments to account for magnetic-field dose effects and excludes patients with MRI contraindications or who cannot tolerate scanning. Data on appointment numbers, timing, and questionnaire scores will be collected and compared between groups.
Who should consider this trial
Good fit: Adults (18+) with confirmed metastatic spinal cord compression referred for an 8 Gy single-fraction palliative radiotherapy who can give informed consent, complete questionnaires, and attend The Christie (Manchester) for urgent treatment are ideal candidates.
Not a fit: Patients who cannot undergo MRI (contraindications or intolerance), have uncontrolled pain, lack capacity or consent, or who require a different radiotherapy regimen or surgical management are unlikely to benefit from the MR one-stop pathway.
Why it matters
Potential benefit: If successful, the approach could shorten time to palliative radiotherapy, reduce the number of hospital visits, and speed symptom relief for patients with metastatic cord compression.
How similar studies have performed: MR-guided single-visit palliative radiotherapy is a relatively novel approach with preliminary modelling and early feasibility work but no large definitive trials in this exact setting to date.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Confirmed Diagnosis of MSCC * Referred for an 8Gy, Single Fraction of Radiotherapy * 18 years or older. * Able to give informed consent in writing or verbally. * Willing to complete patient experience questionnaire * Willing to have the research team review their case notes for up to 1 year following Exclusion Criteria: * Participant does not have capacity and cannot give informed consent. * Any evidence of significant clinical disorder or laboratory finding which, in the opinion of the investigator, make it undesirable for the patient to participate in the study. * Participant is unwilling to allow researchers to access their clinical notes and diagnostic scans. * Participant is unwilling to complete an experience questionnaire * The participant cannot speak or understand English. Exclusion Criteria MRL arm: * Any contraindications to MRI identified after MRI safety screening * Unable to tolerate MRI scanning * Uncontrolled pain/ poor pain control. * MSCC in the cervical spine. * More than one vertebral level of compression
Where this trial is running
Manchester
- The Christie NHS Foundation Trust — Manchester, United Kingdom (Recruiting)
Study contacts
- Principal investigator: Cynthia L Eccles — The Christie NHS Foundation Trust
- Study coordinator: Clinical Trial Radiographer
- Email: the-christie.radiotherapyclinicaltrials@nhs.net
- Phone: +441614468386
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.