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Time-Dose Considerations May Affect Radiation Myelopathy

JAMA. 1964;190(3):41. doi:10.1001/jama.1964.03070160099050.
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ABSTRACT

Reduced fractionation schedules in radiotherapy appear to increase the possibility of radiation myelopathy, two investigators at the Medical Research Center, Brookhaven National Laboratory, Upton, NY, reported to the seventh Symposium Neuroradiologicum.

Harold L. Atkins, MD, and Patricia Tretter, MD, reviewed 14 patients at the Columbia-Presbyterian Medical Center who developed necrosis of the spinal cord as a result of radiation therapy.

All but one were treated with unconventional fractionation techniques. The number of treatments varied from one to 26 and the probable cord dose from 830 to 5,200 rads (r). Half of the patients were treated for carcinoma of the breast; three had lung cancer. The remaining patients had cancer of the tongue and esophagus, cylindroma of the trachea, and Hodgkin's disease.

Treatment Was Varied  Four patients with cancer of the breast were treated as part of an experimental series and received 2,380 r in two divided doses a week apart.

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