Critical organs and Treatment doses
Kidney TD 5/5
23 Gy Nephritis
Testicular TREATMENT DOSE
25 Gy Boost to 35 Gy Seminoma Lymphatics: Periaortic (use extended SSD's)
Lacrimal Gland- TD 5/5
26 Gy dry eye
Ear TD 5/5
30-55 Gy Acute and chronic serous otitis
Parotid- TD 5/5
32 Gy Xerostomia
Heart TD 5/5
40 Gy pericarditis
Uterine/Cervix TREATMENT DOSE
40-50 Gy Squamous cell Include cervical os
Stomach TREATMENT DOSE
45 Gy Boost to 50-55 Gy Adenocarcinoma
Anus TREATMENT DOSE
45 Gy Boost to 60-65 Gy Squamous cell Lymphatics: Inguinal Boost to inguinal nodes
Thyroid- TD 5/5
45 Gy thyroiditis
Larynx (vocal cords)- TD 5/5
45 edema
Endometrium TREATMENT DOSE
45-50 Gy Adenocarcinoma (most common GYN malignancy)
Pituitary Tumors TREATMENT DOSE
45-50 Gy Boost to 54 Gy Histologically benign Treat with chin tucked
IM field TREATMENT DOSE
50 Gy
Optic Chiasm & Optic Nerve- TD 5/5
50 Gy Blindness
Optic Nerve -- TD 5/5
50 Gy Blindness
Ethmoid Sinus TREATMENT DOSE
50 Gy Boost to 70 Gy Adenocarcinoma
Brain stem TD 5/5
50 Gy Necrosis/ infarction
Esophagus TD 5/5
55 Gy clinical stricture/ perforation
stomach- TD 5/5
55 Gy ulceration/perforation
Parotid TREATMENT DOSE
55- 60 Gy Boost to 65 Gy (Largest salivary gland)
Brachial plexus TD 5/5
55-60 Gy clinical nerve damage
Bladder & Rectum TD 5/5
65 Gy Symptomatic contracture/ volume loss
Lens- TD 5/5
10 Gy cataract
Lung TD 5/5
14-17.5 Gy Pneumonitis
Whole Brain TREATMENT DOSE
30 Gy used for multiple lesions
Liver TD 5/5
30 Gy liver failure
Hodgkin's disease TREATMENT DOSE
36-44 Gy AP/PA Mantle, Inverted Y, Pelvic
Pancreas TREATMENT DOSE
40-45 Gy Boost to 60 Gy Adenocarcinoma Sx tx Whipple
Lung TREATMENT DOSE
40-45 Gy Boost to 65-70 Gy Non-small cell, small cell, Squamous cell, Adenocarcinoma Spread: Liver, Brain, Bone
Colon/Rectum TREATMENT DOSE
45 Gy Boost to 50 Gy Adenocarcinoma
Small bowel TD 5/5
45 Gy obstruction/perforaration
Colon TD 5/5
45 Gy obstruction/perforation/ulceration/fistula
Supraclavicular TREATMENT DOSE
45 Gy to a depth of 3cm
Bladder TREATMENT DOSE
45-50 Gy Boost to 64 Gy Transitional cell
Spinal Cord - TD 5/5
47 Gy Myelitis/ Necrosis
Brain (temporal lobe)- TD 5/5
47 Gy Necrosis/ infarction
Esophagus TREATMENT DOSE
50 Gy Boost to 60-65 Gy Squamous cell Risk factor Barrett's esophagus
Floor of Mouth, Tongue TREATMENT DOSE
50 Gy Boost to 70 Gy Lymphatics: Jugulodigastric, Midjugular, Submaxillary
Maxillary Sinus TREATMENT DOSE
50 Gy Boost to 70 Gy Squamous cell Lymphatics: Rarely involved
Hypopharynx TREATMENT DOSE
50 Gy Boost to 70 Gy Squamous cell (most common is pyriform sinus) Lymphatics: Jugulodigastric, Midjugular, Parapharyngeal
Oropharynx TREATMENT DOSE
50 Gy Boost to 70-75 Gy Lymphatics: Jugulodigastric, Retropharyngeal, Submaxillary
Nasopharynx TREATMENT DOSE
50 Gy Boost to75 Gy Squamous cell (risk factor Epstein Barr) Lymphatics: Jugulodigastric, Retropharyngeal, Deep cervical **Must include the base of skull**
Breast TREATMENT DOSE
50.4 Gy Boost to 60 Gy Lymphatics: Axillary, Internal Mammary Transpectoral
Gliomas TREATMENT DOSE
60 Gy Primary brain tumor
TMJ/ Mandible TD 5/5
60 Gy limitation of joint function
Oral Cavity TREATMENT DOSE
60-70 Gy Squamous cell Lymphatics: Jugulodigastric, Submental, Submaxillary
Larynx (cartilage)- TD 5/5
70 Gy cartilage necrosis
Prostate TREATMENT DOSE
75-81 Gy (44 treatments) Adenocarcinoma Lymphatics: Obturation, Periprostatic, Internal iliac, External iliac, Common iliac, Presciatic, Presacral
Larynx TREATMENT DOSE
Approx 66 Gy Squamous cell (most common head and neck cancer) Lymphatics: Not normally involved
Spinal Cord TREATMENT DOSE
only go to 4500 cGy