• Int. J. Radiat. Oncol. Biol. Phys. · Mar 2010

    Review Meta Analysis

    Radiation dose-volume effects in the spinal cord.

    • John P Kirkpatrick, Albert J van der Kogel, and Timothy E Schultheiss.
    • Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA. jkirk@radonc.duke.edu
    • Int. J. Radiat. Oncol. Biol. Phys. 2010 Mar 1; 76 (3 Suppl): S42-9.

    AbstractDose-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.Copyright 2010 Elsevier Inc. All rights reserved.

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