Spinal cord dose tolerance to stereotactic body radiation therapy Review

  


Authors: Sahgal, A.; Chang, J. H.; Ma, L.; Marks, L. B.; Milano, M. T.; Medin, P.; Niemierko, A.; Soltys, S. G.; Tomé, W. A.; Wong, C. S.; Yorke, E.; Grimm, J.; Jackson, A.
Review Title: Spinal cord dose tolerance to stereotactic body radiation therapy
Abstract: 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 (Dmax) 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 (EQD22) Dmax ≤70 Gy; SBRT thecal sac EQD22 Dmax ≤25 Gy, thecal sac SBRT EQD22 Dmax to cumulative EQD22 Dmax 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. © 2019 The Authors
Keywords: radiotherapy; patient monitoring; stereotactic body radiation therapy; risk perception; reirradiation; spinal cords; equivalent dose; dose tolerance; risk estimates; spinal cord tolerances; minimum time
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 110
Issue: 1
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2021-05-01
Start Page: 124
End Page: 136
Language: English
DOI: 10.1016/j.ijrobp.2019.09.038
PUBMED: 31606528
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85074778645&doi=10.1016%2fj.ijrobp.2019.09.038&partnerID=40&md5=0ebeec855dfbc4c587cb5532383c2e8b
Notes: Article -- Export Date: 3 May 2021 -- Source: Scopus
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  1. Andrew Jackson
    253 Jackson
  2. Ellen D Yorke
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