PURPOSE: To assess the effect of prescription parameters on the dose received by the spine during palliative radiotherapy. MATERIALS AND METHODS: In a survey, members of the Canadian Association of Radiation Oncologists were asked to define their prescription parameters for vertebral metastases. The depth of the spinal canal and vertebral body at 8 spinal levels was measured in 20 magnetic resonance imaging studies (MRIs). Survey results were applied to the measurements to assess the dose received at depth. The depth of spinal structures assessed at simulation and by diagnostic imaging was compared. RESULTS: Prescriptions were most commonly to D(max) 3 cm or 5 cm using 60Co-6MV photons delivering 8-30 Gy in 1-10 fractions. Mean depths from MRI were: posterior spinal canal, 5.5 cm; anterior spinal canal, 6.9 cm; and anterior vertebral body, 9.6 cm. Application of the prescription parameters from the survey to these measurements showed a wide range in the dose at depth with variation in technique. Depths measured at simulation correlated well with diagnostic imaging. CONCLUSION: The spinal canal and vertebral body lie >5 cm beneath the skin, and the dose received varies by up to 50% with changes in prescription depth. We suggest a suitable prescription point for vertebral metastases and a method for determining this at simulation.
PURPOSE: To assess the effect of prescription parameters on the dose received by the spine during palliative radiotherapy. MATERIALS AND METHODS: In a survey, members of the Canadian Association of Radiation Oncologists were asked to define their prescription parameters for vertebral metastases. The depth of the spinal canal and vertebral body at 8 spinal levels was measured in 20 magnetic resonance imaging studies (MRIs). Survey results were applied to the measurements to assess the dose received at depth. The depth of spinal structures assessed at simulation and by diagnostic imaging was compared. RESULTS: Prescriptions were most commonly to D(max) 3 cm or 5 cm using 60Co-6MV photons delivering 8-30 Gy in 1-10 fractions. Mean depths from MRI were: posterior spinal canal, 5.5 cm; anterior spinal canal, 6.9 cm; and anterior vertebral body, 9.6 cm. Application of the prescription parameters from the survey to these measurements showed a wide range in the dose at depth with variation in technique. Depths measured at simulation correlated well with diagnostic imaging. CONCLUSION: The spinal canal and vertebral body lie >5 cm beneath the skin, and the dose received varies by up to 50% with changes in prescription depth. We suggest a suitable prescription point for vertebral metastases and a method for determining this at simulation.
Authors: Nicolas Magné; Cyrus Chargari; René Olivier Mirimanoff; Pierre Olivier; Jean Philippe Vuillez; Michèle Tubiana-Hulin; Jean Jacques Body; Jean Léon Lagrange Journal: Support Care Cancer Date: 2010-08-31 Impact factor: 3.603
Authors: Joanne M van der Velden; Helena M Verkooijen; Enrica Seravalli; Jochem Hes; A Sophie Gerlich; Nicolien Kasperts; Wietse S C Eppinga; Jorrit-Jan Verlaan; Marco van Vulpen Journal: BMC Cancer Date: 2016-11-21 Impact factor: 4.430
Authors: Paulien G Westhoff; Alexander de Graeff; Evelyn M Monninkhof; Ilse de Pree; Marco van Vulpen; Jan Willem H Leer; Corrie A M Marijnen; Yvette M van der Linden Journal: J Radiat Oncol Date: 2017-09-19