Spine radiosurgery: a dosimetric analysis in 124 patients who received 18 Gy
| Autor: | Winston Wen, Samuel Ryu, Jin Koo Kim, S. Schipani, Jain-Yue Jin |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Organs at Risk Cancer Research Cord Maximum Tolerated Dose medicine.medical_treatment Oropharynx Lumbar vertebrae Kidney Radiosurgery Thoracic Vertebrae Esophagus medicine Mucositis Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Aged 80 and over Stomatitis Radiation Lumbar Vertebrae Spinal Neoplasms business.industry Radiotherapy Dosage Middle Aged medicine.disease Spinal cord Radiation therapy Trachea medicine.anatomical_structure Oncology Spinal Cord Thoracic vertebrae Cervical Vertebrae Female Nuclear medicine business |
| Zdroj: | International journal of radiation oncology, biology, physics. 84(5) |
| ISSN: | 1879-355X |
| Popis: | Purpose To define the safely tolerated doses to organs at risk (OARs) adjacent to the target volume (TV) of spine radiosurgery (SRS) with 18-Gy in a single fraction. Methods and Materials A total of 124 patient cases with 165 spine metastases were reviewed. An 18-Gy single-fraction regimen was prescribed to the 90% isodose line encompassing the TV. A constraint of 10 Gy to 10% of the spinal cord outlined 6 mm above and below the TV was used. Dosimetric data to OARs were analyzed. Results A total of 124 patients (100%) were followed-up, and median follow-up time was 7 months (1-50 months). Symptoms and local control were achieved in 114 patients (92%). Acute Radiation Therapy Oncology Group (RTOG) grade 1 oral mucositis occurred in 11 of 11 (100%) patients at risk for oropharyngeal toxicity after cervical spine treatment. There were no RTOG grade 2-4 acute or late complications. Median TV was 43.2 cc (5.3-175.4 cc) and 90% of the TV received median dose of 19 Gy (17-19.8 Gy). Median (range) of spinal cord maximum dose (Dmax), dose to spinal cord 0.35 cc (Dsc0.35), and cord volume receiving 10 Gy (Vsc10) were 13.8 Gy (5.4-21 Gy), 8.9 Gy (2.6-11.4 Gy) and 0.33 cc (0-1.6 cc), respectively. Other OARs were evaluated when in proximity to the TV. Esophagus (n=58), trachea (n=28), oropharynx (n=11), and kidneys (n=34) received median (range) V10 and V15 of 3.1 cc (0-5.8 cc) and 1.2 cc (0-2.9 cc), 2.8 cc (0-4.9 cc), and 0.8 cc (0-2.1 cc), 3.4 cc (0-6.2 cc) and 1.6 cc (0-3.2 cc), 0.3 cc (0-0.8 cc) and 0.08 cc (0-0.1 cc), respectively. Conclusions Cord Dmax of 14 Gy and D0.35 of 10 Gy are safe dose constraints for 18-Gy single-fraction SRS. Esophagus V10 of 3 cc and V15 of 1 cc, trachea V10 of 3 cc, and V15 of 1 cc, oropharynx V10 of 3.5 cc and V15 of 1.5 cc, kidney V10 of 0.3 cc, and V15 of 0.1 cc are planning guidelines when these OARs are in proximity to the TV. |
| Databáze: | OpenAIRE |
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