for people ages 18 years and up (full criteria)
at San Francisco, California and other locations
study started
completion around
Principal Investigator
by Steve Braunstein
Headshot of Steve Braunstein
Steve Braunstein



The purpose of this study is to find out which way of giving high-dose radiation works best for treatment of cancer that has spread to bone, the spine, soft tissue, or lymph nodes. This study will look at the effects, good and/or bad, of giving 27 Gy in three fractions (3 days) or 24 Gy in one fraction (1 day) using image-guided intensity-modulated radiotherapy (IG-IMRT). IG-IMRT is radiation that is given directly to the cancer site and reduces the exposure to normal tissue. Currently there are no studies that compare the effects of giving radiation in either hypofractionated doses (higher total doses of radiation spread out over several treatment days) or a single-fraction dose (entire radiation dose given in one treatment session).

The patient may be asked to participate in an additional part of this study where we will get a a (DW/DCE) MRI before treatment start and within one hour after radiation treatment. If the patient is asked to take part in this portion of the study, all they will need to do is get up to 3 MRIs with standard contrast injection. The purpose of this is to see if as a result of the treatment there are changes in the blood flow going to the cancer which could suggest that the treatment may be successful.

In addition some patients can present new lesions and may be asked if they would like to have these new lesions treated on the protocol. If they are given this option, this will not extend their follow up period. The follow up of the new lesions will match with the prior follow up dates.

Official Title

A Phase III Randomized Study Comparing Two Dosing Schedules for Hypofractionated Image-Guided Radiation Therapy in Patients With Metastatic Cancer


Melanoma, Ovarian Cancer, Sarcoma, Bone, CNS-Spinal CD/MEMBR, NOS, Lymph Nodes, Soft Tissue, radiation, Hypofractionated Image- Guided, IGIMRT, RT, 10-154, IGIMRT using a single dose of 24 Gy, IGIMRT 27 Gy in 3 fractions, stereotactic IGIMRT 27 Gy in 3 fractions


You can join if…

Open to people ages 18 years and up

  • Histologically or cytologically confirmed diagnosis of cancer (including epithelial carcinoma, sarcoma, and melanoma) The diagnosis can be done at MSKCC or at participating institutions.
  • Sites of metastatic disease to be treated on protocol are limited to bone, spine, soft tissue, and lymph nodes only.
  • Patients with American Joint Committee on Cancer (6th edition, 2002) Stage IV cancer with distant metastases
  • Age 18 years or older
  • Life expectancy >3 months
  • Maximum tumor dimension of ≤6 cm in lymph nodes, soft tissue, osseous metastases, or spinal metastases seen on imaging (computed tomography [CT], magnetic resonance imaging [MRI], or PET/CT) and considered amenable for RT.
  • If the lesion(s) to be treated are soft-tissue or lymph Nodes unidimensionally measurable disease is required. Bone & spine lesions are eligible even if considered non-measurable.
  • Measurable disease is defined as:
  • ≥ 10mm for soft-tissue lesions
  • ≥ 15mm on the short axis of lymph nodes
  • KPS ≥ 80
  • Patients must have normal bone marrow function as defined below:(within 2 months of registration) Hemoglobin ≥9.0 g/dl Absolute neutrophil count (ANC) ≥1,500/μl Platelets ≥100,000/μl

You CAN'T join if...

  • Prior radiotherapy delivered to the target region
  • Disease to be treated on protocol is less than 2 mm from the spinal cord and therefore will not meet dose constraints*
  • Pregnancy or Breast-Feeding (Participants of child-bearing potential are eligible but must consent to using effective contraception during therapy and for at least 3 months after completing therapy).
  • Chemotherapy given on the day of the planned radiotherapy treatment
  • Lesions which comprise >70% of the width of weight bearing bones, such as the femur.
  • Existing cortical bone destruction, where orthopedic stabilization would be required.
  • Areas to be treated on protocol do not include metastases to liver, brain or lung.
    • Note: Patients with eligible and ineligible lesions will be accrued to this protocol. Only target eligible lesions will be treated per protocol. Other eligible and ineligible lesions will be treated at the discretion of the treating physician."


  • UCSF
    San Francisco California 94143 United States
  • Memorial Sloan Kettering Cancer Center
    New York New York 10065 United States
  • The Champalimaud Centre
    Lisbon Portugal
  • University of Pisa
    Pisa Italy

Lead Scientist at UCSF

  • Steve Braunstein
    Dr. Braunstein is a radiation oncologist with a clinical interest in the treatment of pediatric, central nervous system, and soft tissue malignancies. He has expertise in modern radiation therapy techniques including stereotactic radiotherapy (Gamma Knife, Cyberknife, Linac-based SBRT), intraoperative radiotherapy, and intensity modulated radiation therapy. Dr. Braunstein earned his M.D.


in progress, not accepting new patients
Start Date
Completion Date
Memorial Sloan Kettering Cancer Center
Memorial Sloan Kettering Cancer Center
Phase 3 research study
Study Type
About 220 people participating
Last Updated