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