Radiation Dose-Volume Effects in the Spinal Cord

Journal Article · Mon Mar 01 04:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.04.095· OSTI ID:21372129

Kogel, Albert J. van der ^[1]; Schultheiss, Timothy E ^[2]

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1. Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)
2. Department of Radiation Physics, City of Hope Cancer Center, Duarte, CA (United States)

Dose-volume data for myelopathy in humans treated with radiotherapy (RT) to the spine is reviewed, along with pertinent preclinical data. Using conventional fractionation of 1.8-2 Gy/fraction to the full-thickness cord, the estimated risk of myelopathy is <1% and <10% at 54 Gy and 61 Gy, respectively, with a calculated strong dependence on dose/fraction (alpha/beta = 0.87 Gy.) Reirradiation data in animals and humans suggest partial repair of RT-induced subclinical damage becoming evident about 6 months post-RT and increasing over the next 2 years. Reports of myelopathy from stereotactic radiosurgery to spinal lesions appear rare (<1%) when the maximum spinal cord dose is limited to the equivalent of 13 Gy in a single fraction or 20 Gy in three fractions. However, long-term data are insufficient to calculate a dose-volume relationship for myelopathy when the partial cord is treated with a hypofractionated regimen.

• OSTI ID: 21372129
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 76; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
CENTRAL NERVOUS SYSTEM
DOSES
FRACTIONATED IRRADIATION
IRRADIATION
MEDICINE
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
SKELETON
SPINAL CORD
SURGERY
THERAPY
VERTEBRAE