Radiation dose-volume effects in the spinal cord.

Published

Journal Article (Review)

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.

Full Text

Duke Authors

Cited Authors

  • Kirkpatrick, JP; van der Kogel, AJ; Schultheiss, TE

Published Date

  • March 1, 2010

Published In

Volume / Issue

  • 76 / 3 Suppl

Start / End Page

  • S42 - S49

PubMed ID

  • 20171517

Pubmed Central ID

  • 20171517

Electronic International Standard Serial Number (EISSN)

  • 1879-355X

Digital Object Identifier (DOI)

  • 10.1016/j.ijrobp.2009.04.095

Language

  • eng

Conference Location

  • United States