SBRT2015

Re-irradiation for spinal metastases

Spinal cord tolerance: re-irradiation with hypofractionation ( SBRT) Sahgal IJROBP 2010:

Case-control study: − 5 cases of RM after SBRT − Thecal sack as OAR − Maximum dose to thecal sack − 2Gy equivalent with α/β=2Gy

Clinical Practice:

0% risk of myelopathy if

− Initial course <50Gy (EQD2/2) − SBRT course <25Gy (EQD2/2) − Interval >5 months

SBRT for re-irradiation

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