Solutio in silico

RTOG Dose Constraints

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

Constraint List

RTOG 0415 Prostate



OrganConstraintNotes
BladderD50% < 65 Gy
BladderD35% < 70 Gy
BladderD25% < 75 Gy
BladderD15% < 80 Gy
Penile BulbMean < 51 Gy
RectumD50% < 60 Gy
RectumD35% < 65 Gy
RectumD25% < 70 Gy
RectumD15% < 75 Gy

RTOG 0418 Endometrial



OrganConstraintNotes
BladderD35% < 45 Gy
Femur Head LeftD15% < 30 Gy
Femur Head RightD15% < 30 Gy
RectumD60% < 30 Gy
Small BowelD30% < 40 Gy

RTOG 0436 Esophagus



OrganConstraintNotes
HeartD33% < 50 Gy
HeartD67% < 45 Gy
HeartD100% < 40 Gy
Kidney LeftD33% < 50 Gy
Kidney LeftD67% < 30 Gy
Kidney LeftD100% < 23 Gy
Kidney RightD33% < 50 Gy
Kidney RightD67% < 30 Gy
Kidney RightD100% < 23 Gy
LiverD50% < 35 Gy
LiverD100% < 30 Gy
Spinal CordD100% < 50 GyTreatment length 10 cm
Spinal CordD100% < 47 GyTreatment length 20 cm

RTOG 0522 Head and Neck



OrganConstraintNotes
Brachial Plexus LeftMax < 60 Gy
Brachial Plexus RightMax < 60 Gy
LarynxMax < 45 Gy
Parotid LeftMean < 26 Gy
Parotid LeftD50% < 30 Gy
Parotid RightMean < 26 Gy
Parotid RightD50% < 30 Gy
ParotidsD20cc < 20 Gy
Spinal CordD0.03cc < 48 Gy

RTOG 0529 Anal Canal



OrganConstraintNotes
BladderD50% < 35 Gy
BladderD35% < 40 Gy
BladderD5% < 50 Gy
External GenitaliaD50% < 20 Gy
External GenitaliaD35% < 30 Gy
External GenitaliaD5% < 40 Gy
Femoral Head LeftD50% < 30 Gy
Femoral Head LeftD35% < 40 Gy
Femoral Head LeftD5% < 44 Gy
Femoral Head RightD50% < 30 Gy
Femoral Head RightD35% < 40 Gy
Femoral Head RightD5% < 44 Gy
IliumD50% < 30 Gy
IliumD35% < 40 Gy
IliumD5% < 50 Gy
Large BowelD200cc < 30 Gy
Large BowelD150cc < 35 Gy
Large BowelD20cc < 45 Gy
Small BowelD200cc < 30 Gy
Small BowelD150cc < 35 Gy
Small BowelD20cc < 45 Gy
Small BowelMax < 50 Gy

RTOG 0534 Prostate Bed



OrganConstraintNotes
BladderD70% < 40 GyExcludes CTV and bladder neck
BladderD50% < 65 GyExcludes CTV and bladder neck
Femoral Head LeftD10% < 50 Gy
Femoral Head RightD10% < 50 Gy
RectumD55% < 40 Gy
RectumD35% < 65 Gy

RTOG 0539 Meningioma



OrganConstraintNotes
BrainstemD0.03cc < 55 GyIntermediate Risk (54 Gy)
BrainstemD0.03cc < 60 GyHigh Risk (60 Gy)
Lens LeftD0.03cc < 5 GyIntermediate Risk (54 Gy)
Lens LeftD0.03cc < 7 GyHigh Risk (60 Gy)
Lens RightD0.03cc < 5 GyIntermediate Risk (54 Gy)
Lens RightD0.03cc < 7 GyHigh Risk (60 Gy)
Optic ChiasmD0.03cc < 54 GyIntermediate Risk (54 Gy)
Optic ChiasmD0.03cc < 56 GyHigh Risk (60 Gy)
Optic Nerve LeftD0.03cc < 50 GyIntermediate Risk (54 Gy)
Optic Nerve LeftD0.03cc < 55 GyHigh Risk (60 Gy)
Optic Nerve RightD0.03cc < 50 GyIntermediate Risk (54 Gy)
Optic Nerve RightD0.03cc < 55 GyHigh Risk (60 Gy)
Retina RightD0.03cc < 45 GyIntermediate Risk (54 Gy)
Retina RightD0.03cc < 50 GyHigh Risk (60 Gy)
Retina LeftD0.03cc < 45 GyIntermediate Risk (54 Gy)
Retina LeftD0.03cc < 50 GyHigh Risk (60 Gy)

RTOG 0615 Nasopharynx



OrganConstraintNotes
Brachial Plexus LeftMax < 66 Gy
Brachial Plexus RightMax < 66 Gy
BrainstemMax < 54 Gy
Brainstem PRVD1% < 60 Gy
Cochlea LeftD5% < 55 Gy
Cochlea RightD5% < 55 Gy
EsophagusMean < 45 GyIncludes postcricoid pharynx
Eyeball LeftMax < 50 Gy
Eyeball RightMax < 50 Gy
LarynxMean < 45 Gy
Lens LeftMax < 25 Gy
Lens RightMax < 25 Gy
MandibleMax < 70 GyLower limit
MandibleD1cc < 75 GyUpper limit
Optic ChiasmMax < 50 Gy
Optic Chiasm PRVMax < 54 Gy
Optic Nerve LeftMax < 50 Gy
Optic Nerve PRV LeftMax < 54 Gy
Optic Nerve PRV RightMax < 54 Gy
Optic Nerve RightMax < 50 Gy
Oral CavityMean < 40 Gy
Spinal CordMax < 45 Gy
Spinal Cord PRVD1% < 50 Gy
Temperomandibular JointMax < 70 GyLower limit
Temperomandibular JointD1cc < 75 GyUpper limit

RTOG 0617 Lung



OrganConstraintNotes
Brachial Plexus LeftMax < 66 Gy
Brachial Plexus RightMax < 66 Gy
EsophagusMean < 34 Gy
HeartD33% < 60 Gy
HeartD67% < 45 Gy
HeartD100% < 40 Gy
LungsD37% < 20 GyExcludes CTV
LungsMean < 20 GyExcludes CTV
Spinal CordMax < 50.5 Gy

RTOG 0618 Lung SBRT 3 Fractions



OrganConstraintNotes
Brachial Plexus LeftMax < 24 Gy
Brachial Plexus RightMax < 24 Gy
EsophagusMax < 27 Gy
HeartMax < 30 GyIncludes pericardium
LungsV20Gy < 10 %Excludes GTV, trachea, and bronchus
Main BronchusMax < 30 Gy
PericardiumMax < 30 Gy
SkinMax < 24 Gy
Spinal CordMax < 18 Gy
TracheaMax < 30 Gy

RTOG 0619 Head and Neck



OrganConstraintNotes
Brachial Plexus LeftD5% < 60 Gy
Brachial Plexus LeftMax < 66 Gy
Brachial Plexus RightD5% < 60 Gy
Brachial Plexus RightMax < 66 Gy
LarynxMax < 45 Gy
Parotid LeftMean < 26 Gy
Parotid LeftD50% < 30 Gy
Parotid RightMean < 26 Gy
Parotid RightD50% < 30 Gy
ParotidsD20cc < 20 Gy
Spinal CordD0.03cc < 48 Gy

RTOG 0621 Prostate Bed



OrganConstraintNotes
BladderV50Gy < 60 %
BladderV66.6Gy < 40 %
RectumV50Gy < 50 %
RectumV66.6Gy < 25 %

RTOG 0630 Sarcoma



OrganConstraintNotes
AnusD50% < 30 Gy
BonesD50% < 50 GyWeightbearing only
Femur Head LeftD5% < 60 Gy
Femur Head RightD5% < 60 Gy
JointsD50% < 50 Gy
Kidney LeftD50% < 14 Gy
Kidney RightD50% < 14 Gy
LungsV20Gy < 20 %
SkinD50% < 20 GyLongitudinal stripe
TestisD50% < 3 Gy
VulvaD50% < 30 Gy

RTOG 0631 Spine SBRT 1 Fraction



OrganConstraintNotes
Brachial Plexus LeftD0.035cc < 17.5 GyGrade 3+ neuropathy
Brachial Plexus LeftD3cc < 14 GyGrade 3+ neuropathy
Brachial Plexus RightD0.035cc < 17.5 GyGrade 3+ neuropathy
Brachial Plexus RightD3cc < 14 GyGrade 3+ neuropathy
Cauda EquinaD0.035cc < 16 GyGrade 3+ neuritis
Cauda EquinaD5cc < 14 GyGrade 3+ neuritis
ColonD0.035cc < 18.4 GyGrade 3+ colitis/fistula
ColonD20cc < 14.3 GyGrade 3+ colitis/fistula
DuodenumD0.035cc < 16 GyGrade 3+ ulceration
DuodenumD5cc < 11.2 GyGrade 3+ ulceration
EsophagusD0.035cc < 16 GyGrade 3+ stenosis/fistula
EsophagusD5cc < 11.9 GyGrade 3+ stenosis/fistula
Great VesselsD0.035cc < 37 GyGrade 3+ aneurysm
Great VesselsD10cc < 31 GyGrade 3+ aneurysm
HeartD0.035cc < 22 GyGrade 3+ pericarditis. Pericardium only
HeartD15cc < 16 GyGrade 3+ pericarditis. Pericardium only
IleumD0.035cc < 15.4 GyGrade 3+ enteritis/obstruction
IleumD5cc < 11.9 GyGrade 3+ enteritis/obstruction
JejunumD0.035cc < 15.4 GyGrade 3+ enteritis/obstruction
JejunumD5cc < 11.9 GyGrade 3+ enteritis/obstruction
LarynxD0.035cc < 20.2 GyGrade 3+ stenosis/fistula
LarynxD4cc < 10.5 GyGrade 3+ stenosis/fistula
LungsD1000cc < 7.4 GyGrade 3+ pneumonitis
PericardiumD0.035cc < 22 GyGrade 3+ pericarditis
PericardiumD15cc < 16 GyGrade 3+ pericarditis
RectumD0.035cc < 18.4 GyGrade 3+ proctitis/fistula
RectumD20cc < 14.3 GyGrade 3+ proctitis/fistula
Renal Cortex LeftD200cc < 8.4 GyBasic renal function
Renal Cortex RightD200cc < 8.4 GyBasic renal function
Renal Hilum LeftD66.7% < 10.6 GyGrade 3+ malignant hypertension
Renal Hilum RightD66.7% < 10.6 GyGrade 3+ malignant hypertension
Sacral PlexusD0.035cc < 18 GyGrade 3+ neuropathy
Sacral PlexusD5cc < 14.4 GyGrade 3+ neuropathy
SkinD0.035cc < 26 GyGrade 3+ ulceration
SkinD10cc < 23 GyGrade 3+ ulceration
Small BowelD0.035cc < 15.4 GyGrade 3+ enteritis/obstruction
Small BowelD5cc < 11.9 GyGrade 3+ enteritis/obstruction
Spinal Cord SubvolumeD1.2cc < 7 GyGrade 3+ myelitis. 5-6 mm above/below target
Spinal Cord SubvolumeD0.35cc < 10 GyGrade 3+ myelitis. 5-6 mm above/below target
Spinal Cord SubvolumeD0.035cc < 14 GyGrade 3+ myelitis. 5-6 mm above/below target
StomachD0.035cc < 16 GyGrade 3+ ulceration/fistula
StomachD10cc < 11.2 GyGrade 3+ ulceration/fistula
TracheaD0.035cc < 20.2 GyGrade 3+ stenosis/fistula
TracheaD4cc < 10.5 GyGrade 3+ stenosis/fistula

RTOG 0712 Bladder



OrganConstraintNotes
Femur Head LeftD20% < 50 Gy
Femur Head RightD20% < 50 Gy
RectumD50% < 30 Gy
RectumD10% < 55 Gy

RTOG 0813 Lung SBRT 5 Fractions



OrganConstraintNotes
Brachial Plexus LeftD3cc < 30 GyNeuropathy
Brachial Plexus LeftMax < 32 GyNeuropathy
Brachial Plexus RightD3cc < 30 GyNeuropathy
Brachial Plexus RightMax < 32 GyNeuropathy
EsophagusD5cc < 27.5 GyStenosis/fistula. Non-adjacent wall
EsophagusMax < 105 %Stenosis/fistula. Non-adjacent wall
Great VesselsD10cc < 47 GyAneurysm. Non-adjacent wall
Great VesselsMax < 105 %Aneurysm. Non-adjacent wall
HeartD15cc < 32 GyPericarditis. Pericardium only
HeartMax < 105 %Pericarditis. Pericardium only
LungsD1500cc < 12.5 GyBasic lung function
LungsD1000cc < 13.5 GyPneumonitis
Main BronchusD4cc < 18 GyStenosis/fistula
Main BronchusMax < 105 %Stenosis/fistula
PericardiumD15cc < 32 GyPericarditis
PericardiumMax < 105 %Pericarditis
SkinD10cc < 30 GyUlceration
SkinMax < 32 GyUlceration
Spinal CordD0.25cc < 22.5 GyMyelitis
Spinal CordD0.5cc < 13.5 GyMyelitis
Spinal CordMax < 30 GyMyelitis
TracheaD4cc < 18 GyStenosis/fistula
TracheaMax < 105 %Stenosis/fistula

RTOG 0822 Rectum



OrganConstraintNotes
BladderD40% < 40 Gy
BladderD15% < 45 Gy
BladderMax < 50 Gy
Femur Head LeftD40% < 40 Gy
Femur Head LeftD25% < 45 Gy
Femur Head LeftMax < 50 Gy
Femur Head RightD40% < 40 Gy
Femur Head RightD25% < 45 Gy
Femur Head RightMax < 50 Gy
Small BowelD180cc < 35 Gy
Small BowelD100cc < 40 Gy
Small BowelD65cc < 45 Gy
Small BowelMax < 50 Gy

RTOG 0825 Glioblastoma



OrganConstraintNotes
BrainstemD0.03cc < 60 Gy
Lens LeftD0.03cc < 7 Gy
Lens RightD0.03cc < 7 Gy
Optic ChiasmD0.03cc < 56 Gy
Optic Nerve LeftD0.03cc < 55 Gy
Optic Nerve RightD0.03cc < 55 Gy
Retina LeftD0.03cc < 50 Gy
Retina RightD0.03cc < 50 Gy

RTOG 0915 SBRT Lung 1 Fraction



OrganConstraintNotes
Brachial Plexus LeftD3cc < 14 GyNeuropathy
Brachial Plexus LeftMax < 17.5 GyNeuropathy
Brachial Plexus RightD3cc < 14 GyNeuropathy
Brachial Plexus RightMax < 17.5 GyNeuropathy
EsophagusD5cc < 11.9 ccStenosis/fistula
EsophagusMax < 15.4 GyStenosis/fistula
Great VesselsD10cc < 31 GyAneurysm
Great VesselsMax < 37 GyAneurysm
HeartD15cc < 16 GyPericarditis. Pericardium only
HeartMax < 22 GyPericarditis. Pericardium only
LungsD1500cc < 7 GyBasic lung function
LungsD1000cc < 7.4 GyPneumonitis
Main BronchusD4cc < 10.5 GyStenosis/fistula
Main BronchusMax < 20.2 GyStenosis/fistula
PericardiumD15cc < 16 GyPericarditis
PericardiumMax < 22 GyPericarditis
RibD1cc < 22 GyPain/fracture
RibMax < 30 GyPain/fracture
SkinD10cc < 23 GyUlceration
SkinMax < 26 GyUlceration
Spinal CordMax < 14 GyMyelitis
Spinal CordD0.35cc < 10 GyMyelitis
Spinal CordD1.2cc < 7 GyMyelitis
StomachD10cc < 11.2 GyUlceration/fistula
StomachMax < 12.4 GyUlceration/fistula
TracheaD4cc < 10.5 GyStenosis/fistula
TracheaMax < 20.2 GyStenosis/fistula

RTOG 0915 SBRT Lung 4 Fractions



OrganConstraintNotes
Brachial Plexus LeftD3cc < 23.6 GyNeuropathy
Brachial Plexus LeftMax < 27.2 GyNeuropathy
Brachial Plexus RightD3cc < 23.6 GyNeuropathy
Brachial Plexus RightMax < 27.2 GyNeuropathy
EsophagusD5cc < 18.8 ccStenosis/fistula
EsophagusMax < 30 GyStenosis/fistula
Great VesselsD10cc < 43 GyAneurysm
Great VesselsMax < 49 GyAneurysm
HeartD15cc < 28 GyPericarditis. Pericardium only
HeartMax < 34 GyPericarditis. Pericardium only
LungsD1500cc < 11.6 GyBasic lung function
LungsD1000cc < 12.4 GyPneumonitis
Main BronchusD4cc < 15.6 GyStenosis/fistula
Main BronchusMax < 34.8 GyStenosis/fistula
PericardiumD15cc < 28 GyPericarditis
PericardiumMax < 34 GyPericarditis
RibD1cc < 32 GyPain/fracture
RibMax < 40 GyPain/fracture
SkinD10cc < 33.2 GyUlceration
SkinMax < 36 GyUlceration
Spinal CordMax < 26 GyMyelitis
Spinal CordD0.35cc < 20.8 GyMyelitis
Spinal CordD1.2cc < 13.6 GyMyelitis
StomachD10cc < 17.6 GyUlceration/fistula
StomachMax < 27.2 GyUlceration/fistula
TracheaD4cc < 15.6 GyStenosis/fistula
TracheaMax < 34.8 GyStenosis/fistula

RTOG 0937 Lung with PCI



OrganConstraintNotes
Brachial Plexus LeftMax < 40 Gy< 2.5 Gy/fx
Brachial Plexus LeftMax < 36 Gy2.5-3 Gy/fx
Brachial Plexus LeftMax < 30 Gy> 3 Gy/fx
Brachial Plexus RightMax < 40 Gy< 2.5 Gy/fx
Brachial Plexus RightMax < 36 Gy2.5-3 Gy/fx
Brachial Plexus RightMax < 30 Gy> 3 Gy/fx
EsophagusMax < 105 %
HeartMax < 105 %
HeartV45Gy < 30 %
Kidney LeftV18Gy < 25 %
Kidney RightV18Gy < 25 %
LiverD700cc < 18 Gy
LungsMean < 20 Gy
LungsV20Gy < 30 %
PericardiumMax < 105 %
PericardiumV45Gy < 30 %
Small BowelD150cc < 30 Gy3 Gy/fx
Small BowelD100cc < 35 Gy3 Gy/fx
Small BowelD50cc < 40 Gy3 Gy/fx
Small BowelD1cc < 45 Gy3 Gy/fx
Small BowelMax < 50 Gy3 Gy/fx
Small BowelD100cc < 30 Gy4 Gy/fx
Small BowelD50cc < 35 Gy4 Gy/fx
Small BowelD1cc < 40 Gy4 Gy/fx
Small BowelMax < 45 Gy4 Gy/fx
Spinal CordMax < 40 Gy< 2.5 Gy/fx
Spinal CordMax < 36 Gy2.5-3 Gy/fx
Spinal CordMax < 30 Gy> 3 Gy/fx

RTOG 1016 Oropharynx



OrganConstraintNotes
Brainstem PRVD0.03cc < 52 Gy
EsophagusMean < 30 GyCervical
LarynxMean < 20 Gy
LipsMean < 20 Gy
MandibleMax < 66 Gy
Oral CavityMean < 30 GyNon-involved
Oral CavityMax < 60 GyNon-involved
Parotid LeftMean < 26 Gy
Parotid RightMean < 26 Gy
PharynxD33% < 50 GyNon-involved
PharynxD15% < 60 GyNon-involved
PharynxMean < 45 GyNon-involved
Spinal Cord PRVD0.03cc < 48 GyLower limit
Spinal Cord PRVD0.03cc < 50 GyUpper limit
Submandibular Gland LeftMean < 39 Gy
Submandibular Gland RightMean < 39 Gy
Temperomandibular JointMax < 66 Gy