Radiation myelopathy of the cervical spinal cord: time, dose and volume factors
| Autor: | Roussel A, Abbatucci Js, T. Delozier, Brune D, Quint R |
|---|---|
| Rok vydání: | 1978 |
| Předmět: |
Cancer Research
Time Factors medicine.medical_treatment Central nervous system Myelitis Spinal Cord Diseases Myelopathy medicine Methods Distribution (pharmacology) Humans Radiology Nuclear Medicine and imaging Radiation Injuries Radiation myelopathy Radiation business.industry Radiotherapy Dosage medicine.disease Spinal cord Radiation therapy medicine.anatomical_structure Oncology Head and Neck Neoplasms Maximum dose business Nuclear medicine |
| Zdroj: | International journal of radiation oncology, biology, physics. 4(3-4) |
| ISSN: | 0360-3016 |
| Popis: | The aim of the present study was to define the respective importance of dose and volume in the development of permanent radiation myelopathy of the cervical cord. The procedure adopted was to compare the radiation parameters of two groups: • ⊎ 12 patients in whom myelopathy developed, of 1715 patients who were treated at our centre. • ⊎ 236 patients in whom no neurological signs were observed, retained as controls. An analysis of the maximum dose delivered to the spinal cord showed that there is practically no risk of inducing myelopathy with a dose lower than 5500 rad (27 fractions, 37 days) and that complications are almost inevitable following a dose greater than 7000 rad (35 fractions, 49 days). A joint analysis of the dose and the number of vertebrae irradiated revealed that high doses can be tolerated without damage if they are delivered to a small number of vertebrae. A study of the anteroposterior distribution of the dose confirmed the importance of the volume: a homogenous high dose entails a higher risk of complications. These analyses permit the definition of a tolerance dose. The dose suggested is 5000 rad (25 fractions, 35 days) when 3–5 vertebrae are irradiated homogenously. A comparison of our results with those published in the literature demonstrates the validity of the tolerance dose suggested in the present study. |
| Databáze: | OpenAIRE |
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