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01.Vertebral Compression Fractures from Spinal Metastases: Imaging and Application of Kyphoplasty and Vertebroplasty (p. 63-71)
02.Bone Metastases and Quality of Life (p. 117-131)
03.Defining Oncologic Spinal Instability (p. 55-61)
04.Bisphosphonates in the Management of Bone Metastases (p. 91-97)
05.Evaluation of Photodynamic Therapy as Treatment for Spinal Metastases (p. 83-91)
06.Less Invasive Surgical Approaches for Spine Metastases (p. 73-81)
07.Management of Malignant Spinal Cord Compression (p. 43-53)
08.Palliative Radiotherapy of Bone Metastases and Pain Flare (p. 105-115)
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Spinal Cord Tolerance to Radiation (p. 99-104) $45.00
Authors:  Arjun Sahgal
Radiation myelopathy is the most feared late toxicity associated with radiation exposure to the spinal cord. As a result, most radiation oncologists are conservative in the total dose to be exposed to the spinal cord eventhough this toxicity is a rare event. In order to guide safe practice, early work done by the University of Toronto help set a safe spinal cord dose limit for conventional radiotherapy and provided guidelines as to re-treatment tolerance. In the new era of radiation delivery and use of stereotactic body radiotherapy for spine tumors, the spinal cord has now the potential to be exposed to high dose per fraction hypofractionated radiotherapy. Previous traditional dose tolerance limits do not apply with this approach, and the question arises as to what dose limits should be used for the spinal cord given SBRT. Research has been done in this regard, led by the University of Toronto, to characterize safe radiation dose limits to the spinal cord for hypofractionated SBRT practice. 

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Spinal Cord Tolerance to Radiation (p. 99-104)