Abstract
Experimental animal data give evidence of long-term recovery of the spinal cord after irradiation. By extrapolation of these data, re-irradiation regimens were designed for eight patients who required palliative radiotherapy. As a consequence of re-irradiation, their spinal cords were exposed to cumulative doses exceeding the tolerance dose. Radiobiological and clinical data are presented. Eight patients were re-irradiated on the cervical (n = 1), thoracic (n = 5) and lumbar (n = 2) spinal cord. The time interval between the initial and re-treatment ranged from 4 months to 12.7 years (median: 2.5 years). (Re-)treatment schemes were designed and analyzed on basis of the biologically effective dose (BED) according to the linear-quadratic model. The repair capacity (alpha/beta ratio) for the cervico-thoracic and lumbar spinal cord was assumed to be 2 Gy and 4 Gy, with a BEDtolerance of 100 Gy and 84 Gy, respectively. The cumulative irradiation dose applied to the spinal cord varied between 125 and 172% of the BEDtolerance. During follow-up, ranging from 33 days to > 4.5 years (median: 370 days) none of the patients developed neurological complications. Seven patients died from tumor progression, and one patient is still alive. Long-term recovery of the spinal cord from radiation injury, which has been demonstrated in rodents and primates, may also occur in humans
Original language | English |
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Pages (from-to) | 453-456 |
Number of pages | 4 |
Journal | Strahlentherapie und Onkologie |
Volume | 178 |
Issue number | 8 |
DOIs | |
Publication status | Published - Aug 2002 |
Keywords
- Bone Neoplasms
- Brain Neoplasms
- Breast Neoplasms
- Carcinoma, Non-Small-Cell Lung
- Carcinoma, Renal Cell
- Carcinoma, Small Cell
- Cervical Vertebrae
- Dose Fractionation
- Follow-Up Studies
- Hodgkin Disease
- Humans
- Kidney Neoplasms
- Linear Models
- Lumbar Vertebrae
- Lung Neoplasms
- Palliative Care
- Radiotherapy Dosage
- Sarcoma, Ewing
- Spinal Cord/radiation effects
- Thoracic Vertebrae
- Thymoma
- Thymus Neoplasms
- Time Factors