Stereotactic body radiotherapy (SBRT) delivers a highly conformal and hypofractionated radiation dose to a small target with minimal radiation applied to the surrounding areas. The spine is an ideal site for SBRT owing to its relative immobility, the potential clinical benefits of high-dose delivery to this area, and the presence of adjacent critical structures such as the spinal cord, esophagus, and bowel. However, with the potential for radiation myelopathy if the dose is delivered inaccurately or if the spinal cord dose limit is set too high, proper treatment planning techniques for SBRT are important. Intensity modulation techniques are useful for spinal SBRT because of a rapid dose falloff and spinal cord avoidance. In this chapter, various planning techniques will be discussed and reviewed.
Part of the book: Ionizing and Non-ionizing Radiation