RADIOGENE MYELITIS NACH AKZELERIERTER RADIOTHERAPIE

We report a case of suspected radiation-induced myelitis after twice-daily irradiation with a cord dose of 45.8 Gy. The 48-year old patient had been irradiated with two daily fractions of 1.8 Gy up to 70.2 Gy for oropharyngeal cancer T4 N2 G3 M0 and achieved a complete remission. The spinal cord received 42 Gy by open fields plus 3.8 Gy scatter irradiation after field reduction. Six months after radiotherapy clinical signs of tetraparesis occurred with two lesions in the cervical cord on MR-images. A complete neurological diagnostic procedure revealed no other causes than suspected radiation damage. This is the only case of radiation myelitis among 90 patients treated twice daily and over 2000 patients irradiated with conventional fractionation in the same technique and doses.