Course book Advanced Treatment Planning 2018

Locoregional RT – Organs at risk

Organ at risk Acute toxicity

Late toxicity

Dose constraint

Skin

radiation dermatitis

Teleangiectasia

ALARA*

(Contralateral) breast

oedema

tumor induction, teleangiectasia, fibrosis

ALARA* < 1 Gy if age ≤ 40 year < 5 Gy if age > 40 year V10Gy < 5% V5Gy < 10% mean heart dose < 3 Gy (V25Gy < 10%)

Heart

pericarditis

valvular dysfunction cardiomyopathy atherosclerosis

Lungs

radiation pneumonitis lung fibrosis

Mean lung dose < 7 Gy

Esophagus

radiation esophagitis stenosis, fistula

ALARA* (Dmean < 45 Gy)

Spinal cord

myelopathy

Dmax 50 Gy (α/β 2)

Brachial plexus

plexopathy (paralysis)

Dmax 66 Gy (α/β 2)

Upper extremity (musculature)

Pain, limited mobility, oedema

ALARA*

*ALARA: As Low As Reasonably Achievable