Spinal Cord Dose Tolerance to Stereotactic Body Radiation Therapy

Journal Article · Sat May 15 04:00:00 EDT 2021 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2019.09.038· OSTI ID:23198582

Sahgal, Arjun ^[1]; Chang, Joe H. ^[1]; Ma, Lijun ^[2]; Marks, Lawrence B. ^[3]; Milano, Michael T. ^[4]; others, and

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1. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)
2. Department of Radiation Oncology, University of California, San Francisco, San Francisco (United States)
3. Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States)
4. Department of Radiation Oncology, University of Rochester, Rochester, New York (United States)

Spinal cord tolerance data for stereotactic body radiation therapy (SBRT) were extracted from published reports, reviewed, and modelled. For de novo SBRT delivered in 1 to 5 fractions, the following spinal cord point maximum doses (D{sub max}) are estimated to be associated with a 1% to 5% risk of radiation myelopathy (RM): 12.4 to 14.0 Gy in 1 fraction, 17.0 Gy in 2 fractions, 20.3 Gy in 3 fractions, 23.0 Gy in 4 fractions, and 25.3 Gy in 5 fractions. For reirradiation SBRT delivered in 1 to 5 fractions, reported factors associated with a lower risk of RM include cumulative thecal sac equivalent dose in 2 Gy fractions with an alpha/beta of 2 (EQD2{sub 2}) D{sub max} ≤70 Gy; SBRT thecal sac EQD2{sub 2} D{sub max} ≤25 Gy, thecal sac SBRT EQD2{sub 2} D{sub max} to cumulative EQD2{sub 2} D{sub max} ratio ≤0.5, and a minimum time interval to reirradiation of ≥5 months. Larger studies containing complete institutional cohorts with dosimetric data of patients treated with spine SBRT, with and without RM, are required to refine RM risk estimates.

• OSTI ID: 23198582
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 110; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
DOSE EQUIVALENTS
HEALTH HAZARDS
PATIENTS
RADIATION DOSES
RADIOTHERAPY
REVIEWS
SPINAL CORD
TOLERANCE
VERTEBRAE