Radiation Therapy to Treat Musculoskeletal Tumors

Description

The study focuses on the following primary Objectives:

* To estimate local control rates with image guided radiation therapy as defined in this study for patients with primary musculoskeletal tumors (MST).

* Prospectively establish a baseline estimate of local control for patients with MST (Ewing’s sarcoma family of tumors (ESFT), rhabdomyosarcoma (RMS) and non-rhabdomyosarcoma soft tissue sarcoma (STS)) treated with image guided radiation therapy.
* Demonstrate that the increased level of conformality afforded by image guided radiation therapy does not reduce its efficacy relative to previously utilized non-image guided radiation therapy techniques in patients with Ewing’s sarcoma family of tumors, resected soft tissue sarcomas, and group III rhabdomyosarcomas.
* Assess local and regional patterns of failure for patients with MST treated with image guided radiation therapy relative to their targeted volumes.
* Provide a long term (>5 year) estimate of local disease control for patients with MST (Ewing’s sarcoma family of tumors (ESFT)), rhabdomyosarcoma (RMS), and non-rhabdomyosarcoma soft tissue sarcoma (STS) treated with image guided radiation therapy.

The study focuses on the following secondary objectives:

* Establish a quantitative baseline estimate of radiation dose-related changes in normal tissues using novel objective measures of somatic change, musculoskeletal function, tissue biochemistry and physiology.

o Investigate the dose and volume relationship for the developing physis and cortical bone using physical measures and imaging evaluations including:
* Prospectively investigate whether an age based radiotherapeutic threshold of dose and volume that will induce premature physis closure and alter long bone length can be quantitatively identified.
* Quantitatively explore the impact of radiation on cortical bone thinning and long bone curvature.
* Relate radiation dose and volume to late (10+ year) alterations in bone integrity.
* Describe the severity and time course of radiation-induced changes in the soft tissues including muscle.

* Delineate sequential changes in muscular volume, muscle function and organ function (delineated by imaging and measures of physical function) following image guided radiation for specific muscular groups.
* Correlate the temporal changes in muscular volume and function with changes in vascularity and metabolism defined by imaging studies.