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Dose Tolerance Guidelines
Adapted from Handbook of Evidence-Based Radiation Oncology (1st Edition)
| Organ | Partial Organ | Tolerance (1.8 - 2.0 Gy/fx) |
|---|---|---|
| Brain | Whole brain Partial brain |
50 Gy 60 Gy |
| Brainstem | Whole Point dose |
54 Gy 60 Gy |
| Spinal cord | 45-50 Gy | |
| Optic chiasm | 50-54 Gy | |
| Optic nerve | <54 Gy | |
| Retina | 45 Gy | |
| Lens | 10 Gy | |
| Inner Ear | 30 Gy Sensorineural 45-50 Gy | |
| Cochlea | 50 Gy | |
| Epilation | 25 Gy | |
| Lacrimal gland | 30 Gy (transient) 60 Gy (permanent) | |
| Parotid gland | V24 Mean |
<50% <26 Gy |
| TMJ | <70 Gy | |
| Mandible | Adult Peds |
60-70 Gy 20-40 Gy |
| Tracheostomy | Elective Involved |
50 Gy 60-66 Gy |
| Thyroid | Peds V20 | 26 Gy |
| Brachial plexus | <60 Gy | |
| Esophagus | 1/3 2/3 |
60 Gy 55-58 Gy |
| Lung | 2/3 volume V20 |
<20 Gy 20-30% |
| Heart | D50 D50 |
<25-40 Gy <25 Gy |
| Stomach | Whole | <45 Gy |
| Liver | D70 Whole liver |
<30 Gy <20 Gy |
| Kidney | 2/3 volume Contralateral kidney |
<20 Gy <20 Gy |
| Small bowel | Small volume Whole |
50 Gy <40 Gy |
| Ureter | <75 Gy | |
| Bladder | Whole Whole |
50 Gy (5-10% late) 60 Gy (10-40% late) |
| Urethra | 60-70 Gy | |
| Rectum | Whole GYN HDR |
60 Gy <70% Point A |
| Femoral head | Adult Slipped epiphysis |
42-50 Gy <25 Gy |
| Testis | Transient azoospermia Total azoospermia |
0.5 Gy 0.8-1 Gy |
| Ovary | Sterilization Ovarian failure |
2-3 Gy 5-10 Gy |
| Vagina | Upper mucosa Mid mucosa |
120 Gy 80-90 Gy |
| Bone marrow | Whole abdomen Ablation |
<30 Gy >40 Gy |
| Bone | Cortex | 50 Gy |
| Joint space | Fibrotic constriction | 40-45 Gy |
| Extremity | Circumferential | 20-30 Gy |