Additional volumetric modulated arc therapy to vertebral metastases abutting the previously irradiated site

Introduction: Lung cancer frequently causes metastases to the spine, especially to the thoracic vertebrae, which sometimes compress the spinal cord and induce irreversible palsy. Many patients suffering from metastatic spinal tumors need to undergo repetitive radiotherapy. In such situations, intensity-modulated radiotherapy including volumetric modulated arc therapy can reduce the dose delivered to the spinal cord at the junction.