Radiation myelopathy of the thoracic spinal cord in long term survivors treated with radical radiotherapy using conventional fractionation

Journal Article · Mon May 01 04:00:00 EDT 1978 · Cancer; (United States)

DOI:https://doi.org/10.1002/1097-0142(197805)41:5<1751::AID-CNCR2820410516>3.0.CO;2-N· OSTI ID:7208153

Lambert, P M

Previous reports on radiation myelopathy of the thoracic spinal cord have attempted to predict tolerance doses as a function of overall treatment time and number of fractions by extrapolation of data from collected myelopathy cases having markedly heterogeneous treatment parameters. A review of long term survivors receiving radical radiotherapy with conventional fractionation for lung and esophageal cancer was undertaken to determine if the proposed tolerance levels were consistent with clinical results in a series of patients constituting the group at risk for developing myelopathy. Spinal cord doses were determined in 58 patients who survived > or = to 18 months following radiotherapy. All patients were treated with megavoltage equipment at dose rates of 200 rads/day continuously (53 patients) or 250 rads/day using split course (5 patients). Tumor doses range from 4500 rads to 7000 rads. Seventeen patients (29%) received less than 5000 rads to the thoracic cord, 6 patients (10%) received 5000 rads, and 35 patients (61%) received greater than 5000 rads. There were two patients who developed myelopathy. Review of our data, the clinical data of others and recent experimental results suggest that the slope of tolerance curves for thoracic spinal cord commonly utilized to express time-dose-fractionation relationships may be inappropriate. It is suggested that cord tolerance to well fractionated radiation has been previously underestimated.

• Research Organization: Tufts-New England Medical Center Hospital, Boston
• OSTI ID: 7208153
• Journal Information: Cancer; (United States), Journal Name: Cancer; (United States) Vol. 41:5; ISSN CANCA
• Country of Publication: United States
• Language: English

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560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
CENTRAL NERVOUS SYSTEM
COBALT 60
COBALT ISOTOPES
DELAYED RADIATION EFFECTS
DIGESTIVE SYSTEM
DISEASES
DOSE-RESPONSE RELATIONSHIPS
ELECTROMAGNETIC RADIATION
ELECTRONS
ELEMENTARY PARTICLES
ESOPHAGUS
EXTERNAL IRRADIATION
FERMIONS
FRACTIONATED IRRADIATION
GAMMA RADIATION
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
IONIZING RADIATIONS
IRRADIATION
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LEPTONS
LUNGS
MEDICINE
MINUTES LIVING RADIOISOTOPES
MYELITIS
NEOPLASMS
NERVOUS SYSTEM
NERVOUS SYSTEM DISEASES
NUCLEAR MEDICINE
NUCLEI
ODD-ODD NUCLEI
ORGANS
PARTIAL BODY IRRADIATION
PATIENTS
RADIATION EFFECTS
RADIATIONS
RADIOINDUCTION
RADIOISOTOPES
RADIOLOGY
RADIOSENSITIVITY
RADIOTHERAPY
RESPIRATORY SYSTEM
SIDE EFFECTS
SPINAL CORD
THERAPY
TIME DEPENDENCE
X RADIATION
YEARS LIVING RADIOISOTOPES