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Locoregional RT – Organs at risk
Organ at risk Acute toxicity
Late toxicity
Dose constraint
Skin
radiation dermatitis
Teleangiectasia
ALARA*
(Contralateral)
breast
oedema
tumor induction,
teleangiectasia, fibrosis
ALARA*
< 1 Gy if age ≤ 40 year
< 5 Gy if age > 40 year
Heart
pericarditis
valvular dysfunction
cardiomyopathy
atherosclerosis
V10Gy < 5%
V5Gy < 10%
mean heart dose < 3 Gy
(V25Gy < 10%)
Lungs
radiation pneumonitis lung fibrosis
Mean lung dose < 7 Gy
Esophagus
radiation esophagitis stenosis, fistula
ALARA*
(Dmean < 45 Gy)
Spinal cord
myelopathy
Dmax 50 Gy (α/β 2)
Brachial plexus
plexopathy (paralysis)
Dmax 66 Gy (α/β 2)
Upper extremity
(musculature)
Pain, limited mobility, oedema
ALARA*
*ALARA: As Low As Reasonably Achievable