TOLERANCE DOSE OF THE SPINAL CORD ON RADIATION MYELOPATHY

The main aim of the present study was to assess the antioxidative effects of human umbilical cord-derived mesenchymal stromal cells (UC-MSCs) in a rat model of radiation myelopathy. UC-MSCs were isolated from Wharton’s jelly (WJ) of umbilical cords. An irradiated cervical spinal cord rat model (C2-T2 segment) was generated using a60Co irradiator to deliver 30 Gy of radiation. UC-MSCs were injected through the tail vein at 90 days, 97 days, 104 days, and 111 days after-irradiation. Histological damage was examined by cresyl violet/Nissl staining. The activities of two antioxidant enzymes catalase (CAT) and glutathione peroxidase (GPX) in the spinal cord were measured by the biomedical assay. In addition, the levels of vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2) in the spinal cord were determined by ELISA methods. Multiple injections of UC-MSCs through the tail vein ameliorated neuronal damage in the spinal cord, increased the activities of the antioxidant enzymes CAT and GPX, and increased the levels of VEGF and Ang-2 in the spinal cord. Our results suggest that multiple injections of UC-MSCs via the tail vein in the rat model of radiation myelopathy could significantly improve the antioxidative microenvironment in vivo.

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Low risk of radiation myelopathy with relaxed spinal cord dose constraints in de novo, single fraction spine stereotactic radiosurgery

Radiotherapy and Oncology ◽

10.1016/j.radonc.2020.07.050 ◽

2020 ◽

Vol 152 ◽

pp. 49-55

Author(s):

Kevin Diao ◽

Juhee Song ◽

Peter F. Thall ◽

Gwendolyn J. McGinnis ◽

David Boyce-Fappiano ◽

...

Keyword(s):

Spinal Cord ◽

Stereotactic Radiosurgery ◽

De Novo ◽

Low Risk ◽

Radiation Myelopathy ◽

Single Fraction ◽

Dose Constraints

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Clinical applicability of biologically effective dose calculation for spinal cord in fractionated spine stereotactic body radiation therapy

Radiology and Oncology ◽

10.1515/raon-2015-0008 ◽

2015 ◽

Vol 49 (2) ◽

pp. 185-191 ◽

Cited By ~ 4

Author(s):

Seung Heon Lee ◽

Kyu Chan Lee ◽

Jinho Choi ◽

So Hyun Ahn ◽

Seok Ho Lee ◽

...

Keyword(s):

Spinal Cord ◽

Radiation Therapy ◽

Effective Dose ◽

Stereotactic Body Radiation Therapy ◽

Maximum Dose ◽

Biologically Effective Dose ◽

Stereotactic Body Radiation ◽

Tolerance Dose ◽

Prescription Dose ◽

Spinal Cord Tolerance

Abstract Background. The aim of the study was to investigate whether biologically effective dose (BED) based on linearquadratic model can be used to estimate spinal cord tolerance dose in spine stereotactic body radiation therapy (SBRT) delivered in 4 or more fractions. Patients and methods. Sixty-three metastatic spinal lesions in 47 patients were retrospectively evaluated. The most frequently prescribed dose was 36 Gy in 4 fractions. In planning, we tried to limit the maximum dose to the spinal cord or cauda equina less than 50% of prescription or 45 Gy2/2. BED was calculated using maximum point dose of spinal cord. Results. Maximum spinal cord dose per fraction ranged from 2.6 to 6.0 Gy (median 4.3 Gy). Except 4 patients with 52.7, 56.4, 62.4, and 67.9 Gy2/2, equivalent total dose in 2-Gy fraction of the patients was not more than 50 Gy2/2 (12.1- 67.9, median 32.0). The ratio of maximum spinal cord dose to prescription dose increased up to 82.2% of prescription dose as epidural spinal cord compression grade increased. No patient developed grade 2 or higher radiationinduced spinal cord toxicity during follow-up period of 0.5 to 53.9 months. Conclusions. In fractionated spine SBRT, BED can be used to estimate spinal cord tolerance dose, provided that the dose per fraction to the spinal cord is moderate, e.g. < 6.0 Gy. It appears that a maximum dose of up to 45-50 Gy2/2 to the spinal cord is tolerable in 4 or more fractionation regimen.

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