Particle Therapy 2017

Spinal toxicity: late…another story !

• Vertebral growth variable: Cervical/Lumbar>thoracic • Posterior ring>body VERTEBRAL . Cervical>Lumbar>thoracic - Dose-gradient correlated: . 15-30 Gy - Age-correlated fusion: . Cervical :10-15 years . Lumbar: 14-16 years . Thoracic: 16-19 years - Anatomically oriented: . Posterior ring to body - Walking posture oriented: . Benefit of AP wedge for Cervical+Lumbar (= Φ lordosis) VERTEBRAL GROWTH - Time oriented:

(Kunos CA et al, Techno cancer Res Treatment , 2008)