QUANTEC Dose Constraints
This page contains the normal tissue dose constraints from the QUANTEC publications, with organ names labeled according to the AAPM TG 263 naming convention. A few notes on the structure names:
- This list only includes the conventional fraction constraints (180-200 cGy per fraction) and does not include the single-fraction SRS constraints. See the HyTEC constraints for published SRS-SBRT constraints.
- The Heart constraints applying only to the pericardium were duplicated to form Pericardium organ constraints.
QUANTEC Constraints (Conventional Fractionation)
| Organ | Constraint | Notes |
| Bladder | Max < 65 Gy | Late grade 3+ toxicity (< 6%). Bladder primary only |
| Bladder | V65Gy < 50 % | Late grade 3+ toxicity. Prostate primary |
| Bladder | V70Gy < 35 % | Late grade 3+ toxicity. Prostate primary |
| Bladder | V75Gy < 25 % | Late grade 3+ toxicity. Prostate primary |
| Bladder | V80Gy < 15 % | Late grade 3+ toxicity. Prostate primary |
| Brain | Max < 60 Gy | Symptomatic necrosis (< 3%) |
| Brain | Max < 72 Gy | Symptomatic necrosis (5%) |
| Brain | Max < 90 Gy | Symptomatic necrosis (10%) |
| Brainstem | Max < 54 Gy | Neuropathy or necrosis (5%). Whole organ irradiated |
| Brainstem | D1cc < 59 Gy | Neuropathy or necrosis (5%). Partial organ irradiated. Lower limit |
| Brainstem | D10cc < 59 Gy | Neuropathy or necrosis (5%). Partial organ irradiated. Upper limit |
| Brainstem | Max < 64 Gy | Neuropathy or necrosis (5%). Partial organ irradiated |
| Cochlea Left | Mean < 45 Gy | Sensory-neural hearing loss (< 30%) |
| Cochlea Right | Mean < 45 Gy | Sensory-neural hearing loss (< 30%) |
| Esophagus | Mean < 34 Gy | Grade 3+ esophagitis (5-20%) |
| Esophagus | V35Gy < 50 % | Grade 2+ esophagitis (< 30%) |
| Esophagus | V50Gy < 40 % | Grade 2+ esophagitis (< 30%) |
| Esophagus | V70Gy < 20 % | Grade 2+ esophagitis (< 30%) |
| Heart | Mean < 26 Gy | Pericarditis (< 15%). Pericardium only |
| Heart | V30Gy < 46 % | Pericarditis (< 15%). Pericardium only |
| Heart | V25Gy < 10 % | Long-term cardiac mortality (< 1%) |
| Kidneys | Mean < 15 Gy | Clinical dysfunction (< 5%). Lower limit |
| Kidneys | Mean < 18 Gy | Clinical dysfunction (< 5%). Upper limit |
| Kidneys | Mean < 28 Gy | Clinical dysfunction (< 50%) |
| Kidneys | V12Gy < 55 % | Clinical dysfunction (< 5%) |
| Kidneys | V20Gy < 32 % | Clinical dysfunction (< 5%) |
| Kidneys | V23Gy < 30 % | Clinical dysfunction (< 5%) |
| Kidneys | V28Gy < 20 % | Clinical dysfunction (< 5%) |
| Larynx | Max < 66 Gy | Vocal dysfunction (< 20%) |
| Larynx | Mean < 50 Gy | Aspiration (< 30%) |
| Larynx | Mean < 44 Gy | Edema (< 20%) |
| Larynx | V50Gy < 27 % | Edema (< 20%) |
| Liver | Mean < 30 Gy | RILD (< 5%). Excludes GTV. No pre-existing liver disease. Lower limit |
| Liver | Mean < 32 Gy | RILD (< 5%). Excludes GTV. No pre-existing liver disease. Upper limit |
| Liver | Mean < 42 Gy | RILD (< 50%). Excludes GTV. No pre-existing liver disease Excludes GTV |
| Liver | Mean < 28 Gy | RILD (< 5%). Excludes GTV. Pre-existing liver disease. Lower limit |
| Liver | Mean < 36 Gy | RILD (< 50%). Excludes GTV. Pre-existing liver disease Excludes GTV |
| Lungs | V20Gy < 30 % | Symptomatic pneumonitis (< 20%) |
| Lungs | Mean < 7 Gy | Symptomatic pneumonitis (< 5%) |
| Lungs | Mean < 13 Gy | Symptomatic pneumonitis (< 10%) |
| Lungs | Mean < 20 Gy | Symptomatic pneumonitis (< 20%) |
| Lungs | Mean < 24 Gy | Symptomatic pneumonitis (< 30%) |
| Lungs | Mean < 27 Gy | Symptomatic pneumonitis (< 40%) |
| Optic Chiasm | Max < 55 Gy | Optic neuropathy (< 3%) |
| Optic Chiasm | Max < 60 Gy | Optic neuropathy (> 7%) |
| Optic Nerve Left | Max < 55 Gy | Optic neuropathy (< 3%) |
| Optic Nerve Left | Max < 60 Gy | Optic neuropathy (> 7%) |
| Optic Nerve Right | Max < 55 Gy | Optic neuropathy (< 3%) |
| Optic Nerve Right | Max < 60 Gy | Optic neuropathy (> 7%) |
| Parotid Left | Mean < 20 Gy | Long-term salivary function < 25% (< 20%). Single parotid sparing only |
| Parotid Right | Mean < 20 Gy | Long-term salivary function < 25% (< 20%). Single parotid sparing only |
| Parotids | Mean < 25 Gy | Long-term salivary function < 25% (< 20%) |
| Parotids | Mean < 39 Gy | Long-term salivary function < 25% (< 20%) |
| Penile Bulb | Mean < 50 Gy | Severe erectile dysfunction (35%) |
| Penile Bulb | D90% < 50 Gy | Severe erectile dysfunction (35%) |
| Penile Bulb | D60% < 70 Gy | Severe erectile dysfunction (55%). Lower limit |
| Penile Bulb | D70% < 70 Gy | Severe erectile dysfunction (55%). Upper limit |
| Pericardium | Mean < 26 Gy | Pericarditis (< 15%) |
| Pericardium | V30Gy < 46 % | Pericarditis (< 15%) |
| Pharynx | Mean < 50 Gy | Symptomatic dysphagia and aspiration (< 20%) |
| Rectum | V50Gy < 50 % | Grade 2+ toxicity (< 15%), grade 3+ toxicity (< 10%). Prostate primary |
| Rectum | V60Gy < 35 % | Grade 2+ toxicity (< 15%), grade 3+ toxicity (< 10%). Prostate primary |
| Rectum | V65Gy < 25 % | Grade 2+ toxicity (< 15%), grade 3+ toxicity (< 10%). Prostate primary |
| Rectum | V70Gy < 20 % | Grade 2+ toxicity (< 15%), grade 3+ toxicity (< 10%). Prostate primary |
| Rectum | V75Gy < 15 % | Grade 2+ toxicity (< 15%), grade 3+ toxicity (< 10%). Prostate primary |
| Small Bowel | V15Gy < 120 cc | Grade 3+ toxicity (< 10%). Individual loops |
| Small Bowel Space | V45Gy < 195 cc | Grade 3+ toxicity (< 10%). Peritoneal cavity |
| Spinal Cord | Max < 50 Gy | Myelopathy (< 0.2%) |
| Spinal Cord | Max < 60 Gy | Myelopathy (< 6%) |
| Spinal Cord | Max < 69 Gy | Myelopathy (< 50%) |
| Stomach | Min < 45 Gy | Ulceration (< 7%) |