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Table 2 Normal tissue dose-volume constraints and standardised contouring nomenclature

From: A randomised phase II trial of Stereotactic Ablative Fractionated radiotherapy versus Radiosurgery for Oligometastatic Neoplasia to the lung (TROG 13.01 SAFRON II)

Organ Standardised name Parameter Investigational treatment
Constraint 28Gy in 1# 48Gy in 4#/2wks
Normal Lungs   V5 < 1000 cc 66 % 7.4Gy 66 % 12.4Gy, (max 3.1Gy per fraction)
Heart Heart Maximum dose (0.03 cc) < 15 cc 22Gy 34 Gy, (max 8.5 Gy per fraction)
16Gy 28 Gy, (max 7 Gy per fraction)
Oesophagus Oesophagus Maximum dose (0.03 cc) 15.4Gy 30Gy, (max 7.5Gy per fraction)
Spinal Cord SpinalCord Maximum dose (0.03 cc) 12Gy 20.8Gy, (max 5.2Gy per fraction)
Brachial plexus BrachialPlexus Maximum dose (0.03 cc) 15Gy 24Gy, (max 6Gy per fraction)
Skin (5 mm subcutis) Skin Maximum dose (0.03 cc) < 10 cc 26Gy 36 Gy, (max 9 Gy per fraction)
23Gy 33.2 Gy, (max 8.3 Gy per fraction)
Chest walla ChestWall <70 cc b26Gy to full thickness 30Gy
Great Vessels GreatVessel Maximum Dose (0.03 cc) 30 Gy 49 Gy, (max 12.25 Gy per fraction
Liver Liver V20, V30 No constraint, but dose/volume parameters to be documented No constraint, but dose/volume parameters to be documented
  1. aChest wall dose limit may be exceeded if rib structure lies close to or in contact with the PTV
  2. b26Gy isodose line should not cross full thickness of the chest wall structure
  3. Definitions: Vx describes the volume that receives xGy, e.g. V5 < 66 % represents that the volume of specified OAR receiving 5 Gy shall be less than 66 %