1244 / 1578
/
ESTRO SBRT 2017 - Matthias Guckenberger
29
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
07.09.17
/
IMRT versus VMAT for spine SBRT
ESTRO SBRT 2017 - Matthias Guckenberger
30
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
07.09.17