Target/organ at risk | Dose | Endpoint | Recommended dose planning aims | Level of evidence | |
Soft constraint | Hard constraint | ||||
High-risk clinical target volume | Dose to 90% of the volume | Local control | >90 Gy EQD210
<95 Gy EQD210 | >85 gy EQD210 | High |
High-risk clinical target volume | D98 | Local control | >80 Gy EQD210 | >75 Gy EQD210 | |
Bladder | D2cm3 | Bleeding, cystitis, fistula | <80 Gy EQD23 | <85 Gy EQD23 | High |
Bladder | International Commission on Radiation Units & Measurements bladder point | Incontinence | <75 Gy EQD23 | <85 Gy EQD23 | High |
Rectum | D2cm3 | Bleeding, proctitis, fistula | <65 Gy EQD23 | <75 Gy EQD23 | High |
Rectum | International Commission on Radiation Units & Measurements rectovaginal point | Bleeding, proctitis, fistula | <65 Gy EQD23 | <75 Gy EQD23 | High |
Sigmoid | D2cm3 | Diarrhea, fistula, strictures, bleeding | <70 Gy EQD23 | <75 Gy EQD23 | No correlation/under investigation |
Bowel | D2cm3 | Fistula, strictures, incontinence, bleeding | <65 Gy EQD23 | <75 Gy EQD23 | High |
Vagina | International Commission on Radiation Units & Measurements rectovaginal point | Vaginal stenosis | <65 Gy EQD23 | <75 Gy EQD23 | High |
D98, dose to 98% of volume; D2cm3, minimum dose to the most exposed 2cm3 of organ wall; EQD23, equivalent dose in 2 Gy fractions (EQD2) using alpha/beta ratios of 3 Gy for organs at risk; EQD210, equivalent dose in 2 Gy fractions (EQD2) using alpha/beta ratios of 10 Gy for tumour volumes; high-risk clinical target volume, adaptive high-risk clinical target volume.