Is SBRT an appropriate treatment for recurrent and unresectable spinal ependymoma?

Topics: Radiation Oncology • Neuro-Oncology

In a patient who received full dose to the spinal cord 10+ years prior, would SBRT be appropriate salvage therapy or is hyperfractionation preferred? What would be an efficacious but safe dose?

Answer from: Radiation Oncologist at Academic Institution

We have reirradiated a handful of patients who had 45-54Gy to the spinal cord 5-12 years ago with another course of RT 50Gy/25 to the cord without any neurologic sequelae--this is unpublished (we are working on it). We have also reirradiated small recurrences after a full course of RT to the s...

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Radiation Oncologist at Yale School of Medicine
Thank you @Yoshiya Yamada. In your series with con...

Radiation Oncologist at Indiana University Health
To piggyback on this, does anyone know if this was...

Answer from: Radiation Oncologist at Academic Institution

Data in the literature based on Anca Grosu's work on re-irradiaiton of spinal cord show that the cumulative dose to the spinal cord can go up to a nominal BED (alpha-beta ratio of 2 and 2 Gy per fx equivalent) of 60-68 Gy without a significant risk of radiaiton myelopathy. All those patients were tr...

Answer from: Radiation Oncologist at Academic Institution

If the recurrent tumor is intramedullary (as opposed to extramedullary), more portions of the spinal cord will be reirradiated.

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