Conformal Radiotherapy for Spinal Lesions

Abstract

In the spine, as elsewhere, conventional doses and treatment schedules in radiotherapy have been titrated to the clinical tolerance of normal tissues. Protracted treatment courses delivered over several weeks, “fractionated schedules,” are a radiobiological compromise employed to permit normal tissue repair between multiple small doses of radiation with the goal of reducing morbid late effects of treatment. Radiotherapy is widely used because this approach is often successful in dealing with microscopic disease or particularly radio-sensitive tumors, however, for bulky disease or radio-resistant tumors, sterilizing tumoricidal doses may never be reached owing to limitations imposed by nearby critical structures such as the spinal cord.