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Do we need dose constraints and DVH
parameters?
Yes !
• Dose needed to control macroscopic tumors is high
• Dose levels different for primary tumors and node metastases
• Dose levels for elective targets 45-50Gy
• Evidence for importance of DVH parameters is constantly increasing
• Dose to OAR should be as low as possible “ALARA”
How to achieve the required dose gradients ?