2017_SBRT_Course Book

Region at highest risk: epidural space

1 Fx 3 Fx 5 Fx 10 Fx 20 Fx

Spinal cord tolerance

10Gy

18Gy

23Gy

35Gy

45Gy

Epidural tumor [EQD2] 17Gy 24Gy 29Gy 39Gy 46Gy Implications for target volume definition / fractionation: Ø More fractionated RT for cases with epidural involvement

/ ESTRO SBRT 2017 - Matthias Guckenberger

07.09.17

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IMRT versus VMAT for spine SBRT

VMAT

Step-and-shoot IMRT

Delivery time: 3.5 min vs 10.5 min

Plan quality: No difference

Lee BJR 2013 • Substantially shorter delivery times • Comparable dosimetric plan quality Ø VMAT preferable for patients in pain

ESTRO SBRT 2017 - Matthias Guckenberger

07.09.17

30

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