Palliative care 2016

Beware of spinal cord toxicity when re-irradiating spinal mets

• Risc scores

• Kans op myelopathie

- Two times 1x 8 Gy → BED2 40 Gy total → 3 rd time -> 60 Gy - Two times 5x 4 Gy → BED2 60 Gy total →… - 10 x 3 Gy → BED2 75 Gy total

Nieder et al. IJROBP 2005 & 2006