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Radiation injury to the spinal cord in head and neck cancers: Does field arrangement have a role
Anusheel Munshi, Prabhakar Ramachandran, Mohanti BidhuKalyan
Abstract
Study Design: A study of eight cases of head and neck cancers, to see if the cord was getting a higher dose in the antero-posterior (A-P) fields, compared to the bilateral(B/L) fields.
Objective: Radiation damage to the spinal cord is a critical issue for the radiation oncologists. This study was conducted to evaluate, if the dose to the spinal cord is higher by the antero-posterior (A-P) fields, compared to the bilateral(B/L) fields.
Materials and Methods: Eight cases of head and neck cancer were taken in our study. Two beam arrangements were placed in the treatment planning system, the B/L and the A-P fields. The DVH's for the cord dose were recorded and compared in both plans, with a standard fraction size of 200cGy/fraction.
Results: The mean dose to the spinal cord was 168.06cGy in A-P arrangement, while it was 133.75cGy in the B/L arrangement.
Conclusion: A-P field arrangement in head and neck malignancies delivers a higher dose to the spinal cord. Therefore, we need to spare the cord at an earlier dose limit.
Keywords
Radiation injury, spinal cord, field arrangement.
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