Lhermitte sign and myelopathy after irradiation of the cervical spinal cord in radiotherapy treatment of head and neck cancer View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-01

AUTHORS

V.E.M. Mul, J.M.A. de Jong, L.H.P. Murrer, P.L.A. van den Ende, R.M.A. Houben, M. Lacko, P. Lambin, B.G. Baumert

ABSTRACT

BACKGROUND AND PURPOSE: The goal of this work was to examine toxicity and risk factors after irradiation of the cervical spinal cord. PATIENTS AND METHODS: A total of 437 patients irradiated for a laryngeal and oropharyngeal carcinoma were eligible (median follow-up 27 months). Spinal cord contouring was defined differently over time as anatomically defined spinal cord area (SCA) and the spinal cord on CT (SC) with a margin of 3 or 5 mm (SCP3/SCP5). RESULTS: None developed chronic progressive radiation myelopathy (CPRM) (maximum spinal dose 21.8-69 Gy); 3.9% (17/437) developed a Lhermitte sign (LS) with a median duration of 6 months (range 1-30 months) and was reversible in all patients. Risk factors for developing LS were younger age (52 vs. 61 years, p < 0.001), accelerated RT (12/17 patients, p < 0.005), and dose-volume relationships for SCA with ≥ 45 Gy of 14.15 cm(3) and 7.9 cm(3) for patients with and without LS, respectively. CONCLUSION: LS is more frequently observed in younger patients and in patients treated with accelerated radiotherapy. A dose-volume relationship was seen for V45 in the case of SCA. For higher doses, no clear dose-volume relationships were observed. More... »

PAGES

71-76

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00066-011-0010-2

DOI

http://dx.doi.org/10.1007/s00066-011-0010-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1028545895

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22194023


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    "description": "BACKGROUND AND PURPOSE: The goal of this work was to examine toxicity and risk factors after irradiation of the cervical spinal cord.\nPATIENTS AND METHODS: A total of 437\u00a0patients irradiated for a laryngeal and oropharyngeal carcinoma were eligible (median follow-up 27\u00a0months). Spinal cord contouring was defined differently over time as anatomically defined spinal cord area (SCA) and the spinal cord on CT (SC) with a margin of 3 or 5\u00a0mm (SCP3/SCP5).\nRESULTS: None developed chronic progressive radiation myelopathy (CPRM) (maximum spinal dose 21.8-69\u00a0Gy); 3.9% (17/437) developed a Lhermitte sign (LS) with a median duration of 6\u00a0months (range 1-30\u00a0months) and was reversible in all patients. Risk factors for developing LS were younger age (52 vs. 61\u00a0years, p\u2009<\u20090.001), accelerated RT (12/17\u00a0patients, p\u2009<\u20090.005), and dose-volume relationships for SCA with \u2265\u200945\u00a0Gy of 14.15\u00a0cm(3) and 7.9\u00a0cm(3) for patients with and without LS, respectively.\nCONCLUSION: LS is more frequently observed in younger patients and in patients treated with accelerated radiotherapy. A dose-volume relationship was seen for V45 in the case of SCA. For higher doses, no clear dose-volume relationships were observed.", 
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