放射治疗正常组织耐受量限值
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What are the recommended dose constraints for the following organs and clinical scenarios?
ORGAN
CONSTRAINTS
CNS (1.8–2.0 Gy/fx)Spinal cord
m ax 50 Gy (full cord cross-section); tolerance increases by 25% 6 mos after 1st course (for re-irradiation) (QUANTEC)
Brain m ax 72 Gy (partial brain); avoid
Ͼ2 Gy/fx or hyperfractionation (QUANTEC)
Chiasm/optic nerves max 55 Gy (QUANTEC)Brainstem E ntire brainstem Ͻ54 Gy , V59 Gy
Ͻ1–10 cc (QUANTEC)
Eyes (globe) M ean Ͻ35 Gy (RTOG 0225), max 54 Gy
(RTOG 0615)
Lens max 7 Gy (RTOG 0539) Retina max 50 Gy (RTOG 0539)Lacrimal Gland max 40 Gy (Parsons)Inner ear/cochlea m ean Յ45 Gy (consider constraining to
Յ35 Gy with concurrent cisplatin) (QUANTEC)
Pituitary gland m ax 45 Gy (for panhypopituitarism,
lower for GH deficiency) (Emami)
Cauda equina M ax 60 Gy (Emami)CNS (single fraction)Spinal cord
m ax 13 Gy (if 3 fxs, max 20 Gy ) (QUANTEC)
APPENDIX
Normal Tissue Constraint
Guidelines
The radiation dose constraints below are meant to serve as a guide only and may not be
applicable to all clinical scenarios. Most doses are derived from randomized studies or consensus guidelines and we have attempted to provide the sources for these recommendations. Please refer to the individual pediatric chapters for dose constraints in the pediatric population as these can vary greatly from protocol to protocol and tend to be particularly site- and age-dependent.
Appendix Normal Tissue Constraint Guidelines
Appendix Normal Tissue Constraint Guidelines
Appendix Normal Tissue Constraint Guidelines