AAPM TG 101 Dose Constraints

This page contains the normal tissue dose constraints from the AAPM TG 101 publication, with organ names labeled according to the AAPM TG 263 naming convention. A few notes on the structure names:

The following structures were duplicated into left and right organs: Brachial Plexus, Cochlea, Femoral Head, and Renal Hilum
The following AAPM TG 101 structures were duplicated into multiple structures:

AAPM TG 101 Label	Constraint Names
Bladder wall	Bladder Wall, Bladder
Spinal cord and medulla	Spinal Cord, Medulla
Heart/pericardium	Heart, Pericardium
Jejunum/ileum	Ileum, Jejunum, Small Bowel
Optic pathway	Optic Chiasm, Optic Nerve Left, Optic Nerve Right
Rib	Rib, Chest Wall
Trachea and large bronchus	Trachea, Main Bronchus

AAPM TG 101 Constraints (1 Fraction)

Organ	Constraint	Notes
Bladder	Max < 18.4 Gy	Cystitis/fistula. Bladder wall only
Bladder	D15cc < 11.4 Gy	Cystitis/fistula. Bladder wall only
Bladder Wall	Max < 18.4 Gy	Cystitis/fistula
Bladder Wall	D15cc < 11.4 Gy	Cystitis/fistula
Brachial Plexus Left	Max < 17.5 Gy	Neuropathy
Brachial Plexus Left	D3cc < 14 Gy	Neuropathy
Brachial Plexus Right	Max < 17.5 Gy	Neuropathy
Brachial Plexus Right	D3cc < 14 Gy	Neuropathy
Brainstem	Max < 15 Gy	Cranial neuropathy. Excludes medulla
Brainstem	D0.5cc < 10 Gy	Cranial neuropathy. Excludes medulla
Bronchus	Max < 13.3 Gy	Stenosis/atelectasis
Bronchus	D0.5cc < 12.4 Gy	Stenosis/atelectasis
Cauda Equina	Max < 16 Gy	Neuritis
Cauda Equina	D5cc < 14 Gy	Neuritis
Chest Wall	Max < 30 Gy	Pain/fracture
Chest Wall	D1cc < 22 Gy	Pain/fracture
Cochlea Left	Max < 9 Gy	Hearing loss
Cochlea Right	Max < 9 Gy	Hearing loss
Colon	Max < 18.4 Gy	Colitis/fistula
Colon	D20cc < 14.3 Gy	Colitis/fistula
Duodenum	Max < 12.4 Gy	Ulceration
Duodenum	D5cc < 11.2 Gy	Ulceration
Duodenum	D10cc < 9 Gy	Ulceration
Esophagus	Max < 15.4 Gy	Stenosis/fistula
Esophagus	D5cc < 11.9 Gy	Stenosis/fistula
Femur Head Left	D10cc < 14 Gy	Necrosis
Femur Head Right	D10cc < 14 Gy	Necrosis
Great Vessels	Max < 37 Gy	Aneurysm. Includes aorta, vena cava, and pulmonary
Great Vessels	D10cc < 31 Gy	Aneurysm. Includes aorta, vena cava, and pulmonary
Heart	Max < 22 Gy	Pericarditis. Pericardium only
Heart	D15cc < 16 Gy	Pericarditis. Pericardium only
Ileum	Max < 15.4 Gy	Enteritis/obstruction
Ileum	D5cc < 11.9 Gy	Enteritis/obstruction
Jejunum	Max < 15.4 Gy	Enteritis/obstruction
Jejunum	D5cc < 11.9 Gy	Enteritis/obstruction
Kidneys	D200cc < 8.4 Gy	Renal function. Renal cortex only
Liver	D700cc < 9.1 Gy	Liver function
Lungs	D1500cc < 7 Gy	Pneumonitis/fibrosis
Lungs	D1000cc < 7.4 Gy	Pneumonitis/fibrosis
Main Bronchus	Max < 20.2 Gy	Stenosis/fistula
Main Bronchus	D4cc < 10.5 Gy	Stenosis/fistula
Medulla	Max < 14 Gy	Myelitis
Medulla	D0.35cc < 10 Gy	Myelitis
Medulla	D1.2cc < 7 Gy	Myelitis
Optic Chaism	Max < 10 Gy	Neuritis
Optic Chaism	D0.2cc < 8 Gy	Neuritis
Optic Nerve Left	Max < 10 Gy	Neuritis
Optic Nerve Left	D0.2cc < 8 Gy	Neuritis
Optic Nerve Right	Max < 10 Gy	Neuritis
Optic Nerve Right	D0.2cc < 8 Gy	Neuritis
Penile Bulb	Max < 34 Gy	Erectile dysfunction
Penile Bulb	D3cc < 14 Gy	Erectile dysfunction
Pericardium	Max < 22 Gy	Pericarditis
Pericardium	D15cc < 16 Gy	Pericarditis
Rectum	Max < 18.4 Gy	Colitis/fistula
Rectum	D20cc < 14.3 Gy	Colitis/fistula
Renal Cortex Left	D200cc < 8.4 Gy	Renal function
Renal Cortex Right	D200cc < 8.4 Gy	Renal function
Renal Hilum Left	Max < 18.6 Gy	Malignant hypertension
Renal Hilum Left	D66.7% < 10.6 Gy	Malignant hypertension
Renal Hilum Right	Max < 18.6 Gy	Malignant hypertension
Renal Hilum Right	D66.7% < 10.6 Gy	Malignant hypertension
Rib	Max < 30 Gy	Pain/fracture
Rib	D1cc < 22 Gy	Pain/fracture
Sacral Plexus	Max < 16 Gy	Neuropathy
Sacral Plexus	D5cc < 14.4 Gy	Neuropathy
Skin	Max < 26 Gy	Ulceration
Skin	D10cc < 23 Gy	Ulceration
Small Bowel	Max < 15.4 Gy	Enteritis/obstruction. Jejunum and ileum
Small Bowel	D5cc < 11.9 Gy	Enteritis/obstruction. Jejunum and ileum
Spinal Cord	Max < 14 Gy	Myelitis
Spinal Cord	D0.35cc < 10 Gy	Myelitis
Spinal Cord	D1.2cc < 7 Gy	Myelitis
Spinal Cord Subvolume	Max < 14 Gy	Myelitis, 5-6 mm above/below target
Spinal Cord Subvolume	D10% < 10 Gy	Myelitis, 5-6 mm above/below target
Stomach	Max < 12.4 Gy	Ulceration
Stomach	D10cc < 11.2 Gy	Ulceration
Trachea	Max < 20.2 Gy	Stenosis/fistula
Trachea	D4cc < 10.5 Gy	Stenosis/fistula

AAPM TG 101 Constraints (3 Fractions)

Organ	Constraint	Notes
Bladder	Max < 28.2 Gy	Cystitis/fistula. Bladder wall only
Bladder	D15cc < 16.8 Gy	Cystitis/fistula. Bladder wall only
Bladder Wall	Max < 28.2 Gy	Cystitis/fistula
Bladder Wall	D15cc < 16.8 Gy	Cystitis/fistula
Brachial Plexus Left	Max < 24 Gy	Neuropathy
Brachial Plexus Left	D3cc < 20.4 Gy	Neuropathy
Brachial Plexus Right	Max < 24 Gy	Neuropathy
Brachial Plexus Right	D3cc < 20.4 Gy	Neuropathy
Brainstem	Max < 23.1 Gy	Cranial neuropathy. Excludes medulla
Brainstem	D0.5cc < 18 Gy	Cranial neuropathy. Excludes medulla
Bronchus	Max < 23.1 Gy	Stenosis/atelectasis
Bronchus	D0.5cc < 18.9 Gy	Stenosis/atelectasis
Cauda Equina	Max < 24 Gy	Neuritis
Cauda Equina	D5cc < 21.9 Gy	Neuritis
Chest Wall	Max < 36.9 Gy	Pain
Chest Wall	D1cc < 28.8 Gy	Pain
Chest Wall	D30cc < 30 Gy	Pain
Cochlea Left	Max < 17.1 Gy	Hearing loss
Cochlea Right	Max < 17.1 Gy	Hearing loss
Colon	Max < 28.2 Gy	Colitis/fistula
Colon	D20cc < 24 Gy	Colitis/fistula
Duodenum	Max < 22.2 Gy	Ulceration
Duodenum	D5cc < 16.5 Gy	Ulceration
Duodenum	D10cc < 11.4 Gy	Ulceration
Esophagus	Max < 25.2 Gy	Stenosis/fistula
Esophagus	D5cc < 17.7 Gy	Stenosis/fistula
Femur Head Left	D10cc < 21.9 Gy	Necrosis
Femur Head Right	D10cc < 21.9 Gy	Necrosis
Great Vessels	Max < 45 Gy	Aneurysm. Includes aorta, vena cava, and pulmonary
Great Vessels	D10cc < 39 Gy	Aneurysm. Includes aorta, vena cava, and pulmonary
Heart	Max < 30 Gy	Pericarditis. Pericardium only
Heart	D15cc < 24 Gy	Pericarditis. Pericardium only
Ileum	Max < 25.2 Gy	Enteritis/obstruction
Ileum	D5cc < 17.7 Gy	Enteritis/obstruction
Jejunum	Max < 25.2 Gy	Enteritis/obstruction
Jejunum	D5cc < 17.7 Gy	Enteritis/obstruction
Kidneys	D200cc < 14.4 Gy	Renal function. Renal cortex only
Liver	D700cc < 17.4 Gy	Liver function
Lungs	D1500cc < 10.5 Gy	Pneumonitis/fibrosis
Lungs	D1000cc < 11.4 Gy	Pneumonitis/fibrosis
Main Bronchus	Max < 30 Gy	Stenosis/fistula
Main Bronchus	D4cc < 15 Gy	Stenosis/fistula
Medulla	Max < 21.9 Gy	Myelitis
Medulla	D0.35cc < 18 Gy	Myelitis
Medulla	D1.2cc < 12.3 Gy	Myelitis
Optic Chaism	Max < 17.4 Gy	Neuritis
Optic Chaism	D0.2cc < 15.3 Gy	Neuritis
Optic Nerve Left	Max < 17.4 Gy	Neuritis
Optic Nerve Left	D0.2cc < 15.3 Gy	Neuritis
Optic Nerve Right	Max < 17.4 Gy	Neuritis
Optic Nerve Right	D0.2cc < 15.3 Gy	Neuritis
Penile Bulb	Max < 42 Gy	Erectile dysfunction
Penile Bulb	D3cc < 21.9 Gy	Erectile dysfunction
Pericardium	Max < 30 Gy	Pericarditis
Pericardium	D15cc < 24 Gy	Pericarditis
Rectum	Max < 28.2 Gy	Colitis/fistula
Rectum	D20cc < 24 Gy	Colitis/fistula
Renal Cortex Left	D200cc < 14.4 Gy	Renal function
Renal Cortex Right	D200cc < 14.4 Gy	Renal function
Rib	Max < 36.9 Gy	Fracture
Rib	D1cc < 28.8 Gy	Fracture
Rib	D30cc < 30 Gy	Fracture
Sacral Plexus	Max < 24 Gy	Neuropathy
Sacral Plexus	D5cc < 22.5 Gy	Neuropathy
Skin	Max < 33 Gy	Ulceration
Skin	D10cc < 30 Gy	Ulceration
Small Bowel	Max < 25.2 Gy	Enteritis/obstruction. Jejunum and ileum
Small Bowel	D5cc < 17.7 Gy	Enteritis/obstruction. Jejunum and ileum
Spinal Cord	Max < 21.9 Gy	Myelitis
Spinal Cord	D0.35cc < 18 Gy	Myelitis
Spinal Cord	D1.2cc < 12.3 Gy	Myelitis
Spinal Cord Subvolume	Max < 21.9 Gy	Myelitis, 5-6 mm above/below target
Spinal Cord Subvolume	D10% < 18 Gy	Myelitis, 5-6 mm above/below target
Stomach	Max < 22.2 Gy	Ulceration
Stomach	D10cc < 16.5 Gy	Ulceration
Trachea	Max < 30 Gy	Stenosis/fistula
Trachea	D4cc < 15 Gy	Stenosis/fistula

AAPM TG 101 Constraints (5 Fractions)

Organ	Constraint	Notes
Bladder	Max < 38 Gy	Cystitis/fistula. Bladder wall only
Bladder	D15cc < 18.3 Gy	Cystitis/fistula. Bladder wall only
Bladder Wall	Max < 38 Gy	Cystitis/fistula
Bladder Wall	D15cc < 18.3 Gy	Cystitis/fistula
Brachial Plexus Left	Max < 30.5 Gy	Neuropathy
Brachial Plexus Left	D3cc < 27 Gy	Neuropathy
Brachial Plexus Right	Max < 30.5 Gy	Neuropathy
Brachial Plexus Right	D3cc < 27 Gy	Neuropathy
Brainstem	Max < 31 Gy	Cranial neuropathy. Excludes medulla
Brainstem	D0.5cc < 23 Gy	Cranial neuropathy. Excludes medulla
Bronchus	Max < 33 Gy	Stenosis/atelectasis
Bronchus	D0.5cc < 21 Gy	Stenosis/atelectasis
Cauda Equina	Max < 32 Gy	Neuritis
Cauda Equina	D5cc < 30 Gy	Neuritis
Chest Wall	Max < 43 Gy	Pain
Chest Wall	D1cc < 35 Gy	Pain
Cochlea Left	Max < 25 Gy	Hearing loss
Cochlea Right	Max < 25 Gy	Hearing loss
Colon	Max < 38 Gy	Colitis/fistula
Colon	D20cc < 25 Gy	Colitis/fistula
Duodenum	Max < 32 Gy	Ulceration
Duodenum	D5cc < 18 Gy	Ulceration
Duodenum	D10cc < 12.5 Gy	Ulceration
Esophagus	Max < 35 Gy	Stenosis/fistula
Esophagus	D5cc < 19.5 Gy	Stenosis/fistula
Femur Head Left	D10cc < 30 Gy	Necrosis
Femur Head Right	D10cc < 30 Gy	Necrosis
Great Vessels	Max < 53 Gy	Aneurysm. Includes aorta, vena cava, and pulmonary
Great Vessels	D10cc < 47 Gy	Aneurysm. Includes aorta, vena cava, and pulmonary
Heart	Max < 38 Gy	Pericarditis. Pericardium only
Heart	D15cc < 32 Gy	Pericarditis. Pericardium only
Ileum	Max < 35 Gy	Enteritis/obstruction
Ileum	D5cc < 19.5 Gy	Enteritis/obstruction
Jejunum	Max < 35 Gy	Enteritis/obstruction
Jejunum	D5cc < 19.5 Gy	Enteritis/obstruction
Kidneys	D200cc < 17.5 Gy	Renal function. Renal cortex only
Liver	D700cc < 21 Gy	Liver function
Lungs	D1500cc < 12.5 Gy	Pneumonitis/fibrosis
Lungs	D1000cc < 13.5 Gy	Pneumonitis/fibrosis
Main Bronchus	Max < 40 Gy	Stenosis/fistula
Main Bronchus	D4cc < 16.5 Gy	Stenosis/fistula
Medulla	Max < 30 Gy	Myelitis
Medulla	D0.35cc < 23 Gy	Myelitis
Medulla	D1.2cc < 14.5 Gy	Myelitis
Optic Chaism	Max < 25 Gy	Neuritis
Optic Chaism	D0.2cc < 23 Gy	Neuritis
Optic Nerve Left	Max < 25 Gy	Neuritis
Optic Nerve Left	D0.2cc < 23 Gy	Neuritis
Optic Nerve Right	Max < 25 Gy	Neuritis
Optic Nerve Right	D0.2cc < 23 Gy	Neuritis
Penile Bulb	Max < 50 Gy	Erectile dysfunction
Penile Bulb	D3cc < 30 Gy	Erectile dysfunction
Pericardium	Max < 38 Gy	Pericarditis
Pericardium	D15cc < 32 Gy	Pericarditis
Rectum	Max < 38 Gy	Colitis/fistula
Rectum	D20cc < 25 Gy	Colitis/fistula
Renal Cortex Left	D200cc < 17.5 Gy	Renal function
Renal Cortex Right	D200cc < 17.5 Gy	Renal function
Renal Hilum Left	D66.7% < 23 Gy	Malignant hypertension
Renal Hilum Right	D66.7% < 23 Gy	Malignant hypertension
Rib	Max < 43 Gy	Pain/fracture
Rib	D1cc < 35 Gy	Pain/fracture
Sacral Plexus	Max < 32 Gy	Neuropathy
Sacral Plexus	D5cc < 30 Gy	Neuropathy
Skin	Max < 39.5 Gy	Ulceration
Skin	D10cc < 36.5 Gy	Ulceration
Small Bowel	Max < 35 Gy	Enteritis/obstruction. Includes jejunum and ileum
Small Bowel	D5cc < 19.5 Gy	Enteritis/obstruction. Includes jejunum and ileum
Spinal Cord	Max < 30 Gy	Myelitis
Spinal Cord	D0.35cc < 23 Gy	Myelitis
Spinal Cord	D1.2cc < 14.5 Gy	Myelitis
Spinal Cord Subvolume	Max < 30 Gy	Myelitis, 5-6 mm above/below target
Spinal Cord Subvolume	D10% < 23 Gy	Myelitis, 5-6 mm above/below target
Stomach	Max < 32 Gy	Ulceration
Stomach	D10cc < 18 Gy	Ulceration
Trachea	Max < 40 Gy	Stenosis/fistula
Trachea	D4cc < 16.5 Gy	Stenosis/fistula