Radiation Oncology/Toxicity/AAPM TG101



Stereotactic Body Radiation Therapy (SBRT): The report of AAPM Task Group 101

2010 PMID 20879569-- "Stereotactic body radiation therapy: The report of AAPM Task Group 101." (Benedict SH, Med Phys. 2010 37;8:4078-101.)

Serial Tissues

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SINGLE FRACTION THREE (3) FRACTIONS FIVE (5) FRACTIONS
Serial Tissue Max Vol Above Threshold 1fx Threshold (Gy) 1fx Dmax (Gy) 3fx Threshold (Gy) 3 fx Dmax (Gy) 5fx Threshold (Gy) 5fx Dmax (Gy) End Point (≥ Grade 3)
Optic Pathway 0.2 cc 8 10 15.3 17.4 23 25 Neuritis
Cochlea N/A N/A 9 N/A 17.1 N/A 25 Hearing Loss
Brainstem (not medulla) < 0.5 cc 10 15 18 23.1 23 31 Cranial Neuropathy
Cord & Medulla < 0.35 cc 10 14 18 21.9 23 30 Myelitis
Cord & Medulla < 1.2 cc 7 14 12.3 21.9 14.5. 30 Myelitis
Cord Subvolume (5-6 mm above and below target) 10% of subvolume 10 14 18 21.9 23 30 Myelitis
Cauda Equina < 5 cc 14 16 21.9 24 30 32 Neuritis
Sacral Plexus < 5 cc 14.4 16 22.5 24 30 32 Neuropathy
Esophagus < 5 cc 11.9 15.4 17.7 25.2 19.5 35 Stenosis / Fistula
Brachial Plexus < 3 cc 14 17.5 20.4 24 27 30.5 Neuropathy
Heart / Pericardium < 15 cc 16 22 24 30 32 38 Pericarditis
Great Vessels < 10 cc 31 37 39 45 47 53 Aneurysm
Trachea & Large Bronchi < 4 cc 10.5 20.2 15 30 16.5 40 Stenosis / Fistula
Bronchi / Small Airways <0.5 cc 12.4 13.3 18.9 23.1 21 33 Stenosis / Atelectasis
Ribs / Chest Wall < 1 cc 22 30 28.8 36.9 35 43 Pain / Fracture
Ribs / Chest Wall < 30 cc N/A N/A 30 36.9 N/A N/A Pain / Fracture
Skin < 10 cc 23 26 30 33 36.5 39.5 Ulceration
Stomach < 10 cc 11.2 12.4 16.5 22.2 18 32 Ulceration
Duodenum < 5 cc 11.2 12.4 16.5 22.2 18 32 Ulceration
Duodenum < 10 cc 9 12.4 11.4 22.2 12.5 32 Ulceration
Jejunum / Ileum < 5 cc 11.9 15.4 17.7 25.2 19.5 35 Enteritis / Obstruction
Colon < 20 cc 14.3 18.4 24 28.2 25 38 Colitis / Fistula
Rectum < 20 cc 14.3 18.4 24 28.2 25 38 Colitis / Fistula
Bladder Wall < 15 cc 11.4 18.4 16.8 28.2 18.3 38 Cystitis / Fistula
Penile Bulb < 3 cc 14 34 21.9 42 30 50 Erectile Dysfunction
Femoral Heads (each) < 10 cc 14 N/A 21.9 N/A 30 N/A Necrosis
Renal Hilum (each) < 2/3rds 10.6 18.6 N/A N/A 23 N/A Malignant Hypertension

Parallel Tissues

Threshold doses for End Point
Parallel Organ Minimum Volume BELOW dose threshold 1 fx (Gy) 3 fx (Gy) 5 fx (Gy)
Lungs 1500 cc

1000 cc

7

7.4

11.6

12.4

12.5

13.5

Pneumonitis / Fibrosis
Liver 700 cc 9.1 19.2 21 Liver function
Renal Cortex 200 cc 8.4 16 17.5 Renal function