ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2021
New clinical data on human spinal cord re-irradiation tolerance.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Tightening the gradient: ten years of dosimetric refinement in head and neck reirradiation.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Article
- Long-Term Results of a Propensity Score Analysis Comparing 5 × 5 Gy and 10 × 3 Gy of Radiotherapy Alone for Malignant Spinal Cord Compression.Journal of clinical medicine · 2025Article
- Radiotherapy with 5 × 5 Gy for Personalized Treatment of Malignant Epidural Compression of the Myelon: Long-Term Results of the PRE-MODE Trial.Journal of personalized medicine · 2025Article
- MR-guided stereotactic radiation therapy for head and neck cancers.Clinical and translational radiation oncology · 2024Article
- Automated planning of stereotactic spine re-irradiation using cumulative dose limits.Physics and imaging in radiation oncology · 2024Article
- Dosimetric evaluation of a spinal cord dose-limiting 3D-CRT technique for radiotherapy of spinal metastases.Journal of applied clinical medical physics · 2023Article
- Review
- Safety and efficacy of salvage conventional re-irradiation following stereotactic radiosurgery for spine metastases.Radiation oncology journal · 2023Article
- The Palliative Care in the Metastatic Spinal Tumors. A Systematic Review on the Radiotherapy and Surgical Perspective.Life (Basel, Switzerland) · 2022Review
- Re-irradiation for intra-thoracic tumours and extra-thoracic breast cancer: dose accumulation, evaluation of efficacy and toxicity based on a literature review.The British journal of radiology · 2022Review
- Reirradiation With Three-Fraction Stereotactic Body Radiation Therapy for Spinal Metastases.Practical radiation oncologyArticle
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo provide additional clinical data about the re-irradiation tolerance of the spinal cord.
methodsThis was a retrospective bi-institutional study of patients re-irradiated to the cervical or thoracic spinal cord with minimum follow-up of 6 months. The maximum dose (Dmax) and dose to 0.1cc (D0.1cc) were determined (magnetic resonance imaging [MRI]-defined cord) and expressed as equivalent dose in 2‑Gy fractions (EQD2) with an α/β value of 2 Gy.
resultsAll 32 patients remained free from radiation myelopathy after a median follow-up of 12 months. Re-irradiation was performed after 6-97 months (median 15). In 22 cases (69%) the re-irradiation spinal cord EQD2 Dmax was higher than that of the first treatment course. Forty-eight of 64 treatment courses employed fraction sizes of 2.5 to 4 Gy to the target volume. The median cumulative spinal cord EQD2 Dmax was 80.7 Gy, minimum 61.12 Gy, maximum 114.79 Gy. The median cumulative spinal cord D0.1cc EQD2 was 76.1 Gy, minimum 61.12 Gy, maximum 95.62 Gy. Besides cumulative dose, other risk factors for myelopathy were present (single-course Dmax EQD2 ≥51 Gy in 9 patients, single-course D0.1cc EQD2 ≥51 Gy in 5 patients).
conclusionEven patients treated to higher cumulative doses than previously recommended, or at a considerable risk of myelopathy according to a published risk score, remained free from this complication, although one must acknowledge the potential for manifestation of damage in patients currently alive, i.e., still at risk. Individualized decisions to re-irradiate after appropriate informed consent are an acceptable strategy, including scenarios where low re-irradiation doses to the spinal cord would compromise target coverage and tumor control probability to an unacceptable degree.
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