Proposal of human spinal cord reirradiation dose based on collection of data from 40 patients

On the basis of these literature data (and with due caution), the risk of myelopathy appears small after ≤135.5 Gy2 when the interval is not shorter than 6 months and the dose of each course is ≤98 Gy2. We would recommend limiting the dose to this level, whenever technically feasible. However, it appears prudent to propose the collection of prospective data from a greater number of patients receiving doses in the range of 136-150 Gy2 to assess the safety of higher retreatment doses for those patients in whom limited doses might compromise tumor control.