Re-irradiation of metastatic spinal cord compression: A feasibility study by volumetric-modulated arc radiotherapy for in-field recurrence creating a dosimetric hole on the central canal

Received 3 July 2009; received in revised form 13 November 2009; accepted 29 November 2009. published online 21 December 2009.

Abstract

When local recurrences arise within an irradiated region involving metastatic spinal cord compression, the dose limit to the spinal cord reduces the chance to re-treat the patient by 3D-conformational RT technique. The possibility of using volumetric modulated arc RT by RapidArc was evaluated for dose sparing at spinal cord level and preserving target coverage. A clinically satisfactory PTV coverage and dose sparing to the spinal cord were obtained. An upcoming trial on patients will provide clinical outcomes.

Keywords: RapidArc, Metastatic spinal cord compression—MSCC, Re-irradiation, Radiotherapy, Volumetric modulated arc therapy

a IRCCS Istituto Clinico Humanitas, Radiation Oncology, Rozzano, Italy

b Oncology Institute of Southern Switzerland, Medical Physics Unit, Bellinzona, Switzerland

c IRCCS Istituto Clinico Humanitas, Medical Oncology, Rozzano, Italy

Corresponding author. Address: IRCCS Istituto Clinico Humanitas, Radiation Oncology, Via Manzoni 56, 20098 Rozzano, Italy.

PII: S0167-8140(09)00649-5

doi:10.1016/j.radonc.2009.11.010

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