Spinal Cord Dose Tolerance to Stereotactic Body Radiation Therapy
International Journal of Radiation Oncology*Biology*Physics(2021)
摘要
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 esti-mated 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. (C) 2019 The Authors. Published by Elsevier Inc.
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关键词
Thecal sac,Spinal cord,Nuclear medicine,Lower risk,Equivalent dose,Medicine,Minimum time,Radiation myelopathy,Stereotactic body radiation therapy
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