Radiation dose-volume effects in the spinal cord.

Abstract

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.

• Authors: John P Kirkpatrick, Albert J van der Kogel, Timothy E Schultheiss
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 76 Issue 3 Suppl Pg. S42-9 (Mar 01 2010) ISSN: 1879-355X [Electronic] United States
• PMID: 20171517 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright 2010 Elsevier Inc. All rights reserved.

Topics

• Age Factors
• Animals
• Dose-Response Relationship, Radiation
• Humans
• Radiation Injuries (etiology)
• Radiation Tolerance
• Radiosurgery (adverse effects)
• Radiotherapy (adverse effects)
• Rats
• Retreatment (adverse effects)
• Spinal Cord (radiation effects)