Radiation Oncology/Toxicity/Hansen

Dose Tolerance Guidelines

Adapted from Handbook of Evidence-Based Radiation Oncology (1st Edition)

Organ	Partial Organ	Tolerance (1.8 - 2.0 Gy/fx)
Brain	Whole brain Partial brain Temporal lobe	50 Gy 60 Gy 70 Gy
Brainstem	Whole Point dose	54 Gy 60 Gy
Spinal cord		45-50 Gy
Optic chiasm		50-54 Gy
Optic nerve		<54 Gy
Retina		45 Gy
Lens		10 Gy
Inner Ear		30 Gy Sensorineural 45-50 Gy
Cochlea		50 Gy
Epilation		25 Gy
Lacrimal gland		30 Gy (transient) 60 Gy (permanent)
Parotid gland	V24 Mean Contralateral	<50% <26 Gy <20 Gy
TMJ		<70 Gy
Mandible	Adult Peds	60-70 Gy 20-40 Gy
Tracheostomy	Elective Involved	50 Gy 60-66 Gy
Thyroid	Peds V20	26 Gy
Brachial plexus		<60 Gy
Esophagus	1/3 2/3 3/3	60 Gy 55-58 Gy 45-55 Gy
Lung	2/3 volume V20 D70 Peds whole lung <1.5 yr Peds whole lung >1.5 yr Peds 2/3	<20 Gy 20-30% <20 Gy 9 Gy 12 Gy <15 Gy
Heart	D50 D50 D70 Peds whole	<25-40 Gy <25 Gy 25-40 Gy <15 Gy
Stomach	Whole	<45 Gy
Liver	D70 Whole liver 1/3 D36 Peds 1/2	<30 Gy <20 Gy 68.4 Gy in 38 fx <30% <19.8 Gy
Kidney	2/3 volume Contralateral kidney Whole abdomen Contralateral Wilms Contralateral Neuroblastoma D80	<20 Gy <20 Gy <15 Gy each <14.4 Gy <12 Gy
Small bowel	Small volume Whole	50 Gy <40 Gy
Ureter		<75 Gy
Bladder	Whole Whole 1/3 1/3 GYN HDR	50 Gy (5-10% late) 60 Gy (10-40% late) 60 Gy (5-10% late) 70 Gy (20% late) <70% Point A
Urethra		60-70 Gy
Rectum	Whole GYN HDR	60 Gy <70% Point A
Femoral head	Adult Slipped epiphysis Avascular necrosis	42-50 Gy <25 Gy 30-40 Gy
Testis	Transient azoospermia Total azoospermia Sterilization	0.5 Gy 0.8-1 Gy 2-3 Gy
Ovary	Sterilization Ovarian failure	2-3 Gy 5-10 Gy
Vagina	Upper mucosa Mid mucosa Lower mucosa Fibrosis/stenosis	120 Gy 80-90 Gy 60-70 Gy >50-60 Gy
Bone marrow	Whole abdomen Ablation	<30 Gy >40 Gy
Bone	Cortex	50 Gy
Joint space	Fibrotic constriction	40-45 Gy
Extremity	Circumferential	20-30 Gy