Course book Advanced Treatment Planning 2018

Parameters for clinical outcome: Small bowel

Irradiation type (partial organ unless otherwise stated)

Volume segmented

Dose (Gy), or dose/volume parameters

Notes on dose/volume parameters

Endpoint

Rate (%)

Volume based on segmentation of the individual loops of bowel , not the entire potential peritoneal space Volume based on the entire potential space within the peritoneal cavity

Individual small bowel loops

Grade > 3 acute toxicity

3D-CRT

V15 <120 cc

<10

Entire potential space within peritoneal cavity

Grade > 3 acute toxicity

3D-CRT

V45 <195 cc

<10

• All data based on series with concurrent chemotherapy • For single fraction SBRT (25 Gy) data are poor , but the cutoff seems to set down to V12.5<30 cc without bowel toxicity

Kavanagh BD et al. Radiation Dose-Volume effects in the stomach and small bowel. Int. J. Radiation Oncology Biol. Phys., Vol. 76, No. 3, Supplement, pp. S101–S107, 2010.