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SBRT for re-irradiation
Spinal cord tolerance:
re-irradiation with hypofractionation ( SBRT)
Sahgal IJROBP 2010:
Case-control study:
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5 cases of RM after SBRT
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Thecal sack as OAR
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Maximum dose to thecal sack
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2Gy equivalent with α/β=2Gy
Clinical Practice:
0% risk of myelopathy if
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Initial course <50Gy (EQD2/2)
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SBRT course <25Gy (EQD2/2)
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Interval >5 months
Re-irradiation for spinal metastases