Course book Advanced Treatment Planning 2018
Parameters for clinical outcome: Brainstem
Irradiation type (partial organ unless otherwise stated)
Dose (Gy), or dose/volume parameters Dmax <54 D1–10 cc < 59
Volume segmented
Notes on dose/volume parameters
Endpoint
Rate (%)
Whole organ 3D-CRT
Permanent cranial neuropathy or necrosis Permanent cranial neuropathy or necrosis Permanent cranial neuropathy or necrosis
<5 <5
Whole organ
Whole organ
3D-CRT
Dmax <64
<5
Point dose <<1 cc
For patients with acoustic tumors
Whole organ
SRS (single fraction)
Dmax <12.5
<5
• Lack of information for dose per fraction in the 4 to 8 Gy range and so there are not affordable recommendations to be followed in the middle fractionations area • The extrapolation of LQ model to the highest doses may however be incorrect
Mayo C et al. Radiation associated brainstem injury. Int. J. Radiation Oncology Biol. Phys., Vol. 76, No. 3, Supplement, pp. S36–S41, 2010.
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