Radiation Oncology/Toxicity/AAPM TG101

Stereotactic Body Radiation Therapy (SBRT): The report of AAPM Task Group 101 2010 PMID 20879569-- "Stereotactic body radiation therapy: The report of AAPM Task Group 101." (Benedict SH, Med Phys. 2010 37;8:4078-101.) 2023 PMID 36695548-- Erratum: “Correction to stereotactic body radiation therapy: The report from the AAPM Task Group No. 101” (Med Phys. 2023. [Med. Phys. 37(8), 4078–4101 (2010)]) Serial Tissues SINGLE FRACTIONTHREE (3) FRACTIONSFIVE (5) FRACTIONS Serial Tissue Max Vol Above Threshold 1fx Threshold (Gy) 1fx Dmax (Gy) 3fx Threshold (Gy) 3 fx Dmax (Gy) 5fx Threshold (Gy) 5fx Dmax (Gy) End Point (≥ Grade 3) Optic Pathway 0.2 cc 8 10 15.3 17.4 23 25 Neuritis Cochlea N/A N/A 9 N/A 17.1 N/A 25 Hearing Loss Brainstem (not medulla) < 0.5 cc 10 15 18 23.1 23 31 Cranial Neuropathy Cord & Medulla < 0.35 cc 10 14 18 21.9 23 30 Myelitis Cord & Medulla < 1.2 cc 7 14 12.3 21.9 14.5. 30 Myelitis Cord Subvolume (5-6 mm above and below target) 10% of subvolume 10 14 18 21.9 23 30 Myelitis Cauda Equina < 5 cc 14 16 21.9 24 30 32 Neuritis Sacral Plexus < 5 cc 14.4 16 22.5 24 30 32 Neuropathy Esophagus < 5 cc 11.9 15.4 17.7 25.2 19.5 35 Stenosis / Fistula Brachial Plexus < 3 cc 14 17.5 20.4 24 27 30.5 Neuropathy Heart / Pericardium < 15 cc 16 22 24 30 32 38 Pericarditis Great Vessels < 10 cc 31 37 39 45 47 53 Aneurysm Trachea & Large Bronchi < 4 cc 10.5 20.2 15 30 16.5 40 Stenosis / Fistula Bronchi / Small Airways <0.5 cc 12.4 13.3 18.9 23.1 21 33 Stenosis / Atelectasis Ribs / Chest Wall < 1 cc 22 30 28.8 36.9 35 43 Pain / Fracture Ribs / Chest Wall < 30 cc N/A N/A 30 36.9 N/A N/A Pain / Fracture Skin < 10 cc 23 26 30 33 36.5 39.5 Ulceration Stomach < 10 cc 11.2 12.4 16.5 22.2 18 32 Ulceration Duodenum < 5 cc 11.2 12.4 16.5 22.2 18 32 Ulceration Duodenum < 10 cc 9 12.4 11.4 22.2 12.5 32 Ulceration Jejunum / Ileum < 5 cc 11.9 15.4 17.7 25.2 19.5 35 Enteritis / Obstruction Colon < 20 cc 14.3 18.4 24 28.2 25 38 Colitis / Fistula Rectum < 20 cc 14.3 18.4 24 28.2 25 38 Colitis / Fistula Bladder Wall < 15 cc 11.4 18.4 16.8 28.2 18.3 38 Cystitis / Fistula Penile Bulb < 3 cc 14 34 21.9 42 30 50 Erectile Dysfunction Femoral Heads (each) < 10 cc 14 N/A 21.9 N/A 30 N/A Necrosis Renal Hilum (each) < 2/3rds 10.6 18.6 N/A N/A 23 N/A Malignant Hypertension Parallel Tissues Threshold doses forEnd PointParallel OrganMinimum Volume BELOW dose threshold1 fx (Gy)3 fx (Gy)5 fx (Gy)Lungs1500 cc 1000 cc7 7.410.5 11.412.5 13.5Pneumonitis / FibrosisLiver700 cc9.117.421Liver functionRenal Cortex200 cc8.414.417.5Renal function