Journal of radiosurgery and SBRT
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Cone beam computed tomography (CBCT) image guidance has become more widely used for spine radiosurgery delivery. Our center began a dedicated spine radiosurgery program that utilizes CBCT image guidance technology for target localization. This study prospectively evaluated the spinal cord and cauda equina doses received during single fraction spine radiosurgery treatments in order to determine a safety profile for this technique. ⋯ The mean maximum point dose to the cauda equina was 11 Gy (range 5-14 Gy), and the mean cauda equina volumes (cm3) receiving greater than 8, 10, and 12 Gy were 1.4 (0-6.68), 0.26 (0-2.99), and 0.02 (0-.39), respectively. This study demonstrates that limiting the spinal cord dose to 10 Gy and the cauda equina dose to 11 Gy can be achieved with therapeutic GTV prescription doses for single fraction spine radiosurgery using CBCT guidance. Such dose constraints are associated with a safe clinical outcome.