How would you manage a radiation induced sarcoma of the spinal cord following R1 resection?
How to treat Radiation Induced Sarcoma (RIS) of the spinal cord after 40 years of postoperative radiation therapy to lower dorsal/upper lumbar ependymoma? The patient is s/p R1 resection.
Answer from: Radiation Oncologist at Academic Institution
Sarcomas, whether radiation-induced or spontaneous, require doses in excess of 60 Gy to control following R1 resection. In this case, the challenge is also associated with the fact that this area of the spinal cord was treated 40 years earlier with presumably cord tolerance doses for an ependymoma. ...