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Dose volume effect for acute bowel, impact of V40 and V15
V40
< 170 cc
V45
< 100 cc
V50
< 33 cc
Incidence of toxicity drops from 21% to 3% when:
175 prostate cancer patients
3D CRT or IMRT
12% acute Gr 2-3 bowel toxicity
153 rectal cancer patients
3-field EBRT with concomitant
chemotherapy
21 % acute G3 diarrhea
Impact of
V15
on diarrhea seemed strongest
V15 should however be seen as a geometrical surrogate
for the high dose volumes and not used alone for
optimizing IMRT dose distribution
Fiorino
IJROBP, 2009
Robertson
IJROBP, 2010