Abstract
The treatment of patients with previously irradiated cord compressions must combine accurate patient positioning with conformal dose delivery to minimize spinal cord dose. By combining daily image guidance in the treatment room with intensity modulated radiation therapy (IMRT), it is possible to deliver a compete second course of therapy without exceeding the currently accepted spinal cord dose TD5 tolerances of 50 to 55 Gy. The purpose of this work is to 1.) Use daily CT imaging and dose reconstruction to determine the level of CT based image guidance required to accurately retreat spinal cord compressions with helical tomotherapy and 2.) Evaluate the level of conformal avoidance that is achievable for helical tomotherapy delivery.
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