Solutio in silico

SRS-SBRT Dose Constraints

This page contains the normal tissue dose constraints for SRS-SBRT, with organ names labeled according to the AAPM TG 263 naming convention. The lists were derived by combining the constraints from HyTEC and AAPM TG 101. Please refer to these pages for additional information. A few notes on the structure names:

Constraint List

SRS-SBRT Constraints (Brain 1 Fraction)



OrganConstraintNotes
BrainV12Gy < 5 ccHyTEC. Symptomatic necrosis (10%)
BrainV12Gy < 10 ccHyTEC. Symptomatic necrosis (10%)
BrainV12Gy < 15 ccHyTEC. Symptomatic necrosis (10%)
BrainstemMax < 15 GyAAPM TG 101. Cranial neuropathy. Excludes medulla
BrainstemD0.5cc < 10 GyAAPM TG 101. Cranial neuropathy. Excludes medulla
Cochlea LeftMax < 9 GyAAPM TG 101. Hearing loss
Cochlea RightMax < 9 GyAAPM TG 101. Hearing loss
Optic ChaismMax < 10 GyAAPM TG 101 & HyTEC. Neuropathy (1%). Lower limit
Optic ChaismMax < 12 GyHyTEC. Neuropathy (1%). Upper limit
Optic ChaismD0.2cc < 8 GyAAPM TG 101. Neuritis
Optic Nerve LeftMax < 10 GyAAPM TG 101 & HyTEC. Neuropathy (1%). Lower limit
Optic Nerve LeftMax < 12 GyHyTEC. Neuropathy (1%). Upper limit
Optic Nerve LeftD0.2cc < 8 GyAAPM TG 101. Neuritis
Optic Nerve RightMax < 10 GyAAPM TG 101 & HyTEC. Neuropathy (1%). Lower limit
Optic Nerve RightMax < 12 GyHyTEC. Neuropathy (1%). Upper limit
Optic Nerve RightD0.2cc < 8 GyAAPM TG 101. Neuritis
Spinal CordMax < 12.4 GyHyTEC. Myelopathy (1-5%). No prior RT. Lower limit
Spinal CordMax < 14 GyAAPM TG 101 & HyTEC. Myelopathy (1-5%). No prior RT. Upper limit
Spinal CordD0.35cc < 10 GyAAPM TG 101. Myelitis
Spinal CordD1.2cc < 7 GyAAPM TG 101. Myelitis

SRS-SBRT Constraints (Lung 3 Fractions)



OrganConstraintNotes
Brachial Plexus LeftMax < 24 GyAAPM TG 101. Neuropathy
Brachial Plexus LeftD3cc < 20.4 GyAAPM TG 101. Neuropathy
Brachial Plexus RightMax < 24 GyAAPM TG 101. Neuropathy
Brachial Plexus RightD3cc < 20.4 GyAAPM TG 101. Neuropathy
BronchusMax < 23.1 GyAAPM TG 101. Stenosis/atelectasis
BronchusD0.5cc < 18.9 GyAAPM TG 101. Stenosis/atelectasis
Chest WallMax < 36.9 GyAAPM TG 101. Pain
Chest WallD1cc < 28.8 GyAAPM TG 101. Pain
Chest WallD30cc < 30 GyAAPM TG 101. Pain
EsophagusMax < 25.2 GyAAPM TG 101. Stenosis/fistula
EsophagusD5cc < 17.7 GyAAPM TG 101. Stenosis/fistula
Great VesselsMax < 45 GyAAPM TG 101. Aneurysm. Includes aorta, vena cava, and pulmonary
Great VesselsD10cc < 39 GyAAPM TG 101. Aneurysm. Includes aorta, vena cava, and pulmonary
HeartMax < 30 GyAAPM TG 101. Pericarditis. Pericardium only
HeartD15cc < 24 GyAAPM TG 101. Pericarditis. Pericardium only
LungsMean < 8 GyHyTEC. Grade 2+ toxicity (10-15%). Excludes target
LungsV20Gy < 10 %HyTEC. Grade 2+ toxicity (10-15%). Excludes target. Lower limit
LungsV20Gy < 15 %HyTEC. Grade 2+ toxicity (10-15%). Excludes target. Upper limit
LungsD1500cc < 10.5 GyAAPM TG 101. Pneumonitis/fibrosis
LungsD1000cc < 11.4 GyAAPM TG 101. Pneumonitis/fibrosis
Main BronchusMax < 30 GyAAPM TG 101. Stenosis/fistula
Main BronchusD4cc < 15 GyAAPM TG 101. Stenosis/fistula
PericardiumMax < 30 GyAAPM TG 101. Pericarditis
PericardiumD15cc < 24 GyAAPM TG 101. Pericarditis
RibMax < 36.9 GyAAPM TG 101. Fracture
RibD1cc < 28.8 GyAAPM TG 101. Fracture
RibD30cc < 30 GyAAPM TG 101. Fracture
Spinal CordMax < 20.3 GyHyTEC. Myelopathy (1-5%). No prior RT. Lower limit
Spinal CordMax < 23.1 GyHyTEC. Myelopathy (1-5%). No prior RT. Upper limit
Spinal CordD0.35cc < 18 GyAAPM TG 101. Myelitis
Spinal CordD1.2cc < 12.3 GyAAPM TG 101. Myelitis
TracheaMax < 30 GyAAPM TG 101. Stenosis/fistula
TracheaD4cc < 15 GyAAPM TG 101. Stenosis/fistula

SRS-SBRT Constraints (Lung 5 Fractions)



OrganConstraintNotes
Brachial Plexus LeftMax < 30.5 GyAAPM TG 101. Neuropathy
Brachial Plexus LeftD3cc < 27 GyAAPM TG 101. Neuropathy
Brachial Plexus RightMax < 30.5 GyAAPM TG 101. Neuropathy
Brachial Plexus RightD3cc < 27 GyAAPM TG 101. Neuropathy
BronchusMax < 33 GyAAPM TG 101. Stenosis/atelectasis
BronchusD0.5cc < 21 GyAAPM TG 101. Stenosis/atelectasis
Chest WallMax < 43 GyAAPM TG 101. Pain
Chest WallD1cc < 35 GyAAPM TG 101. Pain
EsophagusMax < 35 GyAAPM TG 101. Stenosis/fistula
EsophagusD5cc < 19.5 GyAAPM TG 101. Stenosis/fistula
Great VesselsMax < 53 GyAAPM TG 101. Aneurysm. Includes aorta, vena cava, and pulmonary
Great VesselsD10cc < 47 GyAAPM TG 101. Aneurysm. Includes aorta, vena cava, and pulmonary
HeartMax < 38 GyAAPM TG 101. Pericarditis. Pericardium only
HeartD15cc < 32 GyAAPM TG 101. Pericarditis. Pericardium only
LungsMean < 8 GyHyTEC. Grade 2+ toxicity (10-15%). Excludes target
LungsV20Gy < 10 %HyTEC. Grade 2+ toxicity (10-15%). Excludes target. Lower limit
LungsV20Gy < 15 %HyTEC. Grade 2+ toxicity (10-15%). Excludes target. Upper limit
LungsD1500cc < 12.5 GyAAPM TG 101. Pneumonitis/fibrosis
LungsD1000cc < 13.5 GyAAPM TG 101. Pneumonitis/fibrosis
Main BronchusMax < 40 GyAAPM TG 101. Stenosis/fistula
Main BronchusD4cc < 16.5 GyAAPM TG 101. Stenosis/fistula
PericardiumMax < 38 GyAAPM TG 101. Pericarditis
PericardiumD15cc < 32 GyAAPM TG 101. Pericarditis
RibMax < 43 GyAAPM TG 101. Fracture
RibD1cc < 35 GyAAPM TG 101. Fracture
Spinal CordMax < 25.3 GyHyTEC. Myelopathy (1-5%). No prior RT. Lower limit
Spinal CordMax < 28.8 GyHyTEC. Myelopathy (1-5%). No prior RT. Upper limit
Spinal CordD0.35cc < 23 GyAAPM TG 101. Myelitis
Spinal CordD1.2cc < 14.5 GyAAPM TG 101. Myelitis
TracheaMax < 40 GyAAPM TG 101. Stenosis/fistula
TracheaD4cc < 16.5 GyAAPM TG 101. Stenosis/fistula

SRS-SBRT Constraints (Prostate 5 Fractions)



OrganConstraintNotes
BladderV100% < 5 ccHyTEC. Late grade 2+ urinary toxicity (< 20%). Lower limit
BladderV100% < 10 ccHyTEC. Late grade 2+ urinary toxicity (< 20%). Upper limit
Bladder WallMax < 38 GyAAPM TG 101. Cystitis/fistula
Bladder WallD15cc < 18.3 GyAAPM TG 101. Cystitis/fistula
Cauda EquinaMax < 32 GyAAPM TG 101. Neuritis
Cauda EquinaD5cc < 30 GyAAPM TG 101. Neuritis
ColonMax < 38 GyAAPM TG 101. Colitis/fistula
ColonD20cc < 25 GyAAPM TG 101. Colitis/fistula
Femur Head LeftD10cc < 30 GyAAPM TG 101. Necrosis
Femur Head RightD10cc < 30 GyAAPM TG 101. Necrosis
Penile BulbMax < 50 GyAAPM TG 101. Erectile dysfunction
Penile BulbD3cc < 30 GyAAPM TG 101. Erectile dysfunction
RectumMax < 35 GyHyTEC. Late grade 3+ bowel toxicity (< 3%). Lower limit
RectumMax < 38 GyAAPM TG 101 & HyTEC. Late grade 3+ bowel toxicity (< 3%). Upper limit
RectumD20cc < 25 GyAAPM TG 101. Colitis/fistula
Sacral PlexusMax < 32 GyAAPM TG 101. Neuropathy
Sacral PlexusD5cc < 30 GyAAPM TG 101. Neuropathy
Small BowelMax < 35 GyAAPM TG 101. Enteritis/obstruction. Includes jejunum and ileum
Small BowelD5cc < 19.5 GyAAPM TG 101. Enteritis/obstruction. Includes jejunum and ileum
UrethraMax < 38 GyHyTEC. Late grade 2+ urinary toxicity (< 20%). Lower limit
UrethraMax < 42 GyHyTEC. Late grade 2+ urinary toxicity (< 20%). Upper limit