ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2018
Repeat reirradiation of the spinal cord: multi-national expert treatment recommendations.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 23 citations in OpenAlex.
- A prospective audit of thoracic reirradiation practice and peer-review in a high-volume academic center.Technical innovations & patient support in radiation oncology · 2025Article
- Clinical workflow for reirradiation: national consensus recommendations on imaging, treatment planning, dose accumulation, and treatment delivery.Acta oncologica (Stockholm, Sweden) · 2025Article
- Dosimetric evaluation of a spinal cord dose-limiting 3D-CRT technique for radiotherapy of spinal metastases.Journal of applied clinical medical physics · 2023Article
- New clinical data on human spinal cord re-irradiation tolerance.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Article
- Pulsed reduced dose-rate radiotherapy for previously irradiated tumors in the brain and spine.Surgical neurology international · 2021Article
- Management of recurrent or progressive spinal metastases: reirradiation techniques and surgical principles.Neuro-oncology practice · 2020Article
- Automatic image segmentation based on synthetic tissue model for delineating organs at risk in spinal metastasis treatment planning.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2019Article
- Tomotherapy in malignant mesothelioma: a planning study to establish dose constraints.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2019Article
- Management of patients with brain metastases from non-small cell lung cancer and adverse prognostic features: multi-national radiation treatment recommendations are heterogeneous.Radiation oncology (London, England) · 2019Article
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Authors and funding
8 authors at 7 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImproved survival of patients with spinal bone metastases has resulted in an increased number of referrals for retreatment and repeat reirradiation.
methodsA consortium of expert radiation oncologists (RO) has been established with the aim of providing treatment recommendations for challenging clinical scenarios for which there are no established guidelines. In this case, a patient developed local progression of a T5 vertebral lesion after two prior courses of palliative radiotherapy (time interval >12 months, assumed cumulative biologically equivalent dose in 2‑Gy fractions [EQD2] for spinal cord [alpha/beta 2 Gy] 75 Gy). Expert recommendations were tabulated with the aim of providing guidance.
resultsFive of seven RO would offer a third course of radiotherapy, preferably with advanced techniques such as stereotactic radiotherapy. However, the dose-fractionation concepts were heterogeneous (3-20 fractions) and sometimes adjusted to different options for systemic treatment. All five RO would compromise target volume coverage to reduce the dose to the spinal cord. Definition of the spinal cord planning-organ-at-risk volume was heterogeneous. All five RO limited the EQD2 for spinal cord. Two were willing to accept more than 12.5 Gy and the highest EQD2 was 19 Gy.
conclusionsThe increasing body of literature about bone metastases and spinal cord reirradiation has encouraged some expert RO to offer palliative reirradiation with cumulative cord doses above 75 Gy EQD2; however, no consensus was achieved. Strategies for harmonization of clinical practice and development of evidence-based dose constraints are discussed.
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