IMRT 2018

QUANTEC: Recommended Dose Limits

▪ The entire brainstem may be treated to 54 Gy using conventional fractionation with limited risk of severe or permanent neurological effects ▪ Smaller volumes of the brainstem (1–10 cc) may be irradiated to maximum doses of 59 Gy for dose fractions ≤2 Gy ▪ The risk appears to increase markedly at doses >64 Gy. However, there is insufficient information to determine whether there is a further volume effect

Mayo C, Yorke E, Merchant TE. Radiation associated brainstem injury. Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S36-41.