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Spinal Cord Dose Tolerance to Stereotactic Body Radiation Therapy

International Journal of Radiation Oncology*Biology*Physics, ISSN: 0360-3016, Vol: 110, Issue: 1, Page: 124-136
2021
  • 125
    Citations
  • 0
    Usage
  • 246
    Captures
  • 0
    Mentions
  • 34
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    125
  • Captures
    246
  • Social Media
    34
    • Shares, Likes & Comments
      34
      • Facebook
        34

Article Description

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 (D max ) 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 (EQD2 2 ) D max ≤70 Gy; SBRT thecal sac EQD2 2 D max ≤25 Gy, thecal sac SBRT EQD2 2 D max to cumulative EQD2 2 D max 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.

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