Journal of Medical Physics
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Year : 1997  |  Volume : 22  |  Issue : 4  |  Page : 175-177

Application Of ERD To Complied Data On Spinal Cord Myelitis Arriving At Tolerance ERD Value



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J Velmurgan


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The spinal cord, because of its anatomical location, is at risk in large number of radiotherapy treatments. Treatment techniques designed to minimize risk of spinal cord injury, are likely to underdose the tumor, with consequent failure to control the disease. Since radiation myelopathy results in severe and irreversible morbidity, it is important to establish the tolerance dose to the spinal cord. Many clinical studies indicate a dose of 45 Gy in 22 to 25 fractions in 30 to 35 days as the tolerance dose which is on the conservative side, from the point of view of tumor control probability. Deciding spinal cord tolerance on the basis of Extrapolated Response Dose (ERD) would be a better approach. This study was designed to evaluate the effects of prognostic factor ERD on the probability of myelitis, for a compiled retrospective clinical literature data. Patients were classified on the basis of ERD and were statistically correlated with the incidence of myelitis. An ERD limit of 130 Gy appears to be the tolerance bioeffect dose for acceptable level of probability of spinal cord myelitis while designing inovative fractionation schemes in clinical radiotherapy.


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