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Re-irradiation tolerance and recovery
Factors associated with recovery:
• Initial biological dose in relationship to tolerance dose
• Initial volume irradiated
• Time interval between treatment courses
Full – partial recovery
• Lung pneumonitis
• Skin
• Mucosa
Partial recovery
• Plexus
• Spinal cord
• Bone
• Mesenchymal
• Small intestine
No recovery
• Heart
• Lung fibrosis
• Heart
• Bladder
• Kidney
07.09.17
ESTRO SBRT 2017 - Matthias Guckenberger
15
/
Re-irradiation tolerance and recovery
Ø
All organs, which are relevant for acute toxicity in
the palliative setting, show relevant recovery
Full – partial recovery
• Lung pneumonitis
• Skin
• Mucosa
Partial recovery
• Plexus
• Spinal cord
• Bone
• Mesenchymal
• Small intestine
No recovery
• Heart
• Lung fibrosis
• Heart
• Bladder
• Kidney
•
Acute toxicity
•
Relevant for
palliative
RT
•
Late toxicity
•
Relevant for
„
curative
“ RT
07.09.17
ESTRO SBRT 2017 - Matthias Guckenberger
16