ABSTRACT
This chapter summarizes the data on spinal cord tolerances to stereotactic body radiotherapy (SBRT) in both those who have never had prior radiotherapy and those who received prior radiotherapy. The main benefit of spine SBRT is the ability to deliver high doses to the tumor volume while sparing the adjacent organs at risk (OARs). The most important OAR to spare using a spine SBRT technique is the spinal cord, which is typically located in close proximity to the vertebral target volume. Segmenting the spinal cord OAR accurately is critical for safe spinal SBRT practice. MRI is currently the most commonly used imaging tool in the diagnostic assessment of radiation myelopathy. A review of the literature regarding spinal cord tolerance was performed for both de novo and reirradiation SBRT in the Hypofractionation Treatment Effects in the Clinic (HyTEC) review. The data for de novo spine SBRT has been thoroughly reviewed in the HyTEC review.
