Radiation myelopathy of the cervical spinal cord: time, dose, and volume factors

Journal Article · Sun Jan 01 04:00:00 EST 1978 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(78)90144-X· OSTI ID:7286963

Abbatucci, J S; Delozier, T; Quint, R; Roussel, A; Brune, D

The aim of the present study was to define the respective importance of dose and volume in the development of permanent radiation myelopathy of the cervical cord. The procedure adopted was to compare the radiation parameters of two groups: 12 patients in whom myelopathy developed, of 1715 patients who were treated at our centre. 236 patients in whom no neurological signs were observed, retained as controls. An analysis of the maximum dose delivered to the spinal cord showed that there is practically no risk of inducing myelopathy with a dose lower than 5500 rad (27 fractions, 37 days) and that complications are almost inevitable following a dose greater than 7000 rad (35 fractions, 49 days). A joint analysis of the dose and the number of vertebrae irradiated revealed that high doses can be tolerated without damage if they are delivered to a small number of vertebrae. A study of the anteroposterior distribution of the dose confirmed the importance of the volume: a homogenous high dose entails a higher risk of complications. These analyses permit the definition of a tolerance dose. The dose suggested is 5000 rad (25 fractions, 35 days) when 3 to 5 vertebrae are irradiated homogenously. A comparison of our results with those published in the literature demonstrates the validity of the tolerance dose suggested in the present study.

• Research Organization: Center ''Francois Baclesse,'' Caen, Cedex, France
• OSTI ID: 7286963
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 4:3/4; ISSN IOBPD
• Country of Publication: United States
• Language: English

Related Subjects

560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BODY AREAS
CENTRAL NERVOUS SYSTEM
DELAYED RADIATION EFFECTS
DISEASES
DOSE-RESPONSE RELATIONSHIPS
HEAD
MEDICINE
MYELITIS
NECK
NEOPLASMS
NERVOUS SYSTEM
NERVOUS SYSTEM DISEASES
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIATION EFFECTS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SKELETON
SPINAL CORD
THERAPY
TIME DEPENDENCE
VERTEBRAE
VOLUME