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Table 3 Organ at Risk Constraints

From: TROG 15.03 phase II clinical trial of Focal Ablative STereotactic Radiosurgery for Cancers of the Kidney - FASTRACK II

Organ Parameter Dose / Fractionation
26Gy/1Fx 42Gy/3Fx
Spinal canal Maximum dose 0.03 cc < 12Gy point dose 0.03 cc < 18Gy point dose
Skin (5 mm subcutis) Maximum Dose (1.5 cc) < 18Gy < 30Gy
Small Bowel Maximum Dose / Volume 0.03 cc <26Gy
5cc < 22.5Gy
Aim for <13Gy to full circumference of small bowel loop
0.03 cc < 30Gy
30cc ≤ 12.5Gy
Maximum dose covering full circumference of bowel wall ≤12.5Gy ≤22.5Gy
Large Bowel Maximum Dose (1.5 cc) ALARA, aim for <26Gy ALARA, aim for <42Gy
Stomach Maximum Dose
Maximum Volume
1.5 cc < 15.4Gy
5 cc ≤ 22.5Gy
0.03 cc < 30 Gy
5 cc ≤ 22.5Gy
Liver Mean dose, Maximum Volume No constraint, but mean dose and dose to 700 cc to be documented 700 cc < 15Gy
Ipsilateral kidney minus ITV Maximum Dose (1.5 cc), V10Gy ALARA: Minimise volume of high dose regions (> 50% isodose)a ALARA: Minimise volume of high dose regions (> 50% isodose)
Contralateral Kidney V10Gy ≤33% ≤33%
  1. a Ipsilateral Kidney minus ITV should adhere to the ALARA principle. In particular, investigators should focus on minimising high dose regions (> 50% isodose) outside the ITV but within the ipsilateral kidney