Target Volume Determination 2015

What are OARs?

Uncommon toxicity: new OARs or the RVR?

IMRT + chemo

Toxicity rates

Toxicity

Structure

Dose

Occipital scalp epilation Anterior oral mucositis

40%

25% 22% 98% 68% 82%

Occipital scalp

D max D max

> 30 Gy > 34 Gy

Anterior mandible

9%

Nausea Emesis

76% 38% 65%

> 36 Gy

Brainstem

D mean

Hypothyroidism

Thyroid gland Posterior fossa Cerebellum Brainstem

~D min

Acute fatigue G≥2 (PARSPORT)

~D mean ~D max

74%

-

Rosenthal et al. IJROBP 2008;72:747-55. Murthy et al. Head Neck 2014; Gulliford et al. Radiat Oncol 2012;104:205-12.