What radiation dose constraints should be used for the spinal cord in pediatrics?
Should they be context/disease specific?
Should the use of chemotherapy before/after, or during radiotherapy modify these tolerances?
Contexts: extramedullary vs. intradural extramedullary vs. intramedullary tumors
Diseases: low vs. high grade primary solid tumor/sarcoma or low vs. high grade primary CNS tumors
Chemotherapy: are there agents which are considered high risk for myelopathy when combined with radiotherapy?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · NYU Langone Medical Center
Answered on
As part of the PENTEC project (Constine et al., PMID 37999712), I had the privilege of finding all of the cases of pediatric radiation myelitis in the literature. This is modified from our published findings, I encourage you to read the full manuscript if you would like further details (Cooper et al...
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Mednet MemberInvited Expert
Radiation Oncology · University of Toronto
Answered on
I have been going to 50.4-52.2 Gy for large volumes and 54 Gy for small volumes (1.8 Gy per day).
I would be more careful with radiosensitizing chemotherapy – busulfan, cisplatin, etc.
I have not been modifying doses based on histology or location (intramedullary vs extramedullary).
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