< Radiation Oncology < Toxicity
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Stereotactic Body Radiation Therapy (SBRT): The report of AAPM Task Group 101
2010 PMID 20879569-- "Stereotactic body radiation therapy: The report of AAPM Task Group 101." (Benedict SH, Med Phys. 2010 37;8:4078-101.)
Serial Tissues
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| SINGLE FRACTION | THREE (3) FRACTIONS | FIVE (5) FRACTIONS | ||||||
|---|---|---|---|---|---|---|---|---|
| Serial Tissue | Max Vol Above Threshold | 1fx Threshold (Gy) | 1fx Dmax (Gy) | 3fx Threshold (Gy) | 3 fx Dmax (Gy) | 5fx Threshold (Gy) | 5fx Dmax (Gy) | End Point (≥ Grade 3) |
| Optic Pathway | 0.2 cc | 8 | 10 | 15.3 | 17.4 | 23 | 25 | Neuritis |
| Cochlea | N/A | N/A | 9 | N/A | 17.1 | N/A | 25 | Hearing Loss |
| Brainstem (not medulla) | < 0.5 cc | 10 | 15 | 18 | 23.1 | 23 | 31 | Cranial Neuropathy |
| Cord & Medulla | < 0.35 cc | 10 | 14 | 18 | 21.9 | 23 | 30 | Myelitis |
| Cord & Medulla | < 1.2 cc | 7 | 14 | 12.3 | 21.9 | 14.5. | 30 | Myelitis |
| Cord Subvolume (5-6 mm above and below target) | 10% of subvolume | 10 | 14 | 18 | 21.9 | 23 | 30 | Myelitis |
| Cauda Equina | < 5 cc | 14 | 16 | 21.9 | 24 | 30 | 32 | Neuritis |
| Sacral Plexus | < 5 cc | 14.4 | 16 | 22.5 | 24 | 30 | 32 | Neuropathy |
| Esophagus | < 5 cc | 11.9 | 15.4 | 17.7 | 25.2 | 19.5 | 35 | Stenosis / Fistula |
| Brachial Plexus | < 3 cc | 14 | 17.5 | 20.4 | 24 | 27 | 30.5 | Neuropathy |
| Heart / Pericardium | < 15 cc | 16 | 22 | 24 | 30 | 32 | 38 | Pericarditis |
| Great Vessels | < 10 cc | 31 | 37 | 39 | 45 | 47 | 53 | Aneurysm |
| Trachea & Large Bronchi | < 4 cc | 10.5 | 20.2 | 15 | 30 | 16.5 | 40 | Stenosis / Fistula |
| Bronchi / Small Airways | <0.5 cc | 12.4 | 13.3 | 18.9 | 23.1 | 21 | 33 | Stenosis / Atelectasis |
| Ribs / Chest Wall | < 1 cc | 22 | 30 | 28.8 | 36.9 | 35 | 43 | Pain / Fracture |
| Ribs / Chest Wall | < 30 cc | N/A | N/A | 30 | 36.9 | N/A | N/A | Pain / Fracture |
| Skin | < 10 cc | 23 | 26 | 30 | 33 | 36.5 | 39.5 | Ulceration |
| Stomach | < 10 cc | 11.2 | 12.4 | 16.5 | 22.2 | 18 | 32 | Ulceration |
| Duodenum | < 5 cc | 11.2 | 12.4 | 16.5 | 22.2 | 18 | 32 | Ulceration |
| Duodenum | < 10 cc | 9 | 12.4 | 11.4 | 22.2 | 12.5 | 32 | Ulceration |
| Jejunum / Ileum | < 5 cc | 11.9 | 15.4 | 17.7 | 25.2 | 19.5 | 35 | Enteritis / Obstruction |
| Colon | < 20 cc | 14.3 | 18.4 | 24 | 28.2 | 25 | 38 | Colitis / Fistula |
| Rectum | < 20 cc | 14.3 | 18.4 | 24 | 28.2 | 25 | 38 | Colitis / Fistula |
| Bladder Wall | < 15 cc | 11.4 | 18.4 | 16.8 | 28.2 | 18.3 | 38 | Cystitis / Fistula |
| Penile Bulb | < 3 cc | 14 | 34 | 21.9 | 42 | 30 | 50 | Erectile Dysfunction |
| Femoral Heads (each) | < 10 cc | 14 | N/A | 21.9 | N/A | 30 | N/A | Necrosis |
| Renal Hilum (each) | < 2/3rds | 10.6 | 18.6 | N/A | N/A | 23 | N/A | Malignant Hypertension |
Parallel Tissues
| Threshold doses for | End Point | ||||
|---|---|---|---|---|---|
| Parallel Organ | Minimum Volume BELOW dose threshold | 1 fx (Gy) | 3 fx (Gy) | 5 fx (Gy) | |
| Lungs | 1500 cc
1000 cc |
7
7.4 |
11.6
12.4 |
12.5
13.5 |
Pneumonitis / Fibrosis |
| Liver | 700 cc | 9.1 | 19.2 | 21 | Liver function |
| Renal Cortex | 200 cc | 8.4 | 16 | 17.5 | Renal function |
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