Adult reference dose/volume limits

Structure Volume (cc) Total Dose (Gy) Max Dose (Gy) Endpoint Notes Reference
Bladder 15% 80 RTOG 0126
Bladder 25% 75 RTOG 0126
Bladder 35% 70 RTOG 0126
Bladder 50% 65 RTOG 0126
Brachial plexus 5% 60 66 RTOG 0619
Brainstem 1% 60 54 1% of PTV, use either limit RTOG 0225
Chiasm 1% 60 54 1% of PTV, use either limit RTOG 0225
Cochlea (each) 5% 55 RTOG 0615
Constrictor (inferior) Mean 54 Aspiration/stricture 96 patients, no complications Caglar
Constrictor (inferior) 60% 52 Aspiration/stricture 96 patients, no complications Caglar
Constrictor (inferior) 51% 50 Aspiration/stricture 96 patients, no complications Caglar
Duodenun 33% 45 60 Spalding
Ears (inner/middle) Mean 50 RTOG 0225
Esophagus 15% 54 60 Gy, if necessary RTOG 0920
Esophagus 33% 45 50 Gy, if necessary RTOG 0920
Esophagus Mean 35 45 Gy, if necessary RTOG 0920
Eyes 50 RTOG 0615
Eyes Mean 35 RTOG 0225
Femoral heads 25% 45 50 RTOG 0822
Femoral heads 40% 40 50 RTOG 0822
Glottic larynx 45 If possible RTOG 0920
Glottic larynx 21% 50 Aspiration/stricture 96 patients, no complications Caglar
Glottic larynx Mean 48 Aspiration/stricture 96 patients, no complications Caglar
Glottic larynx 60% 47 Aspiration/stricture 96 patients, no complications Caglar
Heart 33% 60 Clinical pericarditis RTOG 0623
Heart 67% 45 Clinical pericarditis RTOG 0623
Heart 100% 40 Clinical pericarditis RTOG 0623
Kidney 33% 50 Renal insufficiency RTOG 0436
Kidney 67% 30 Renal insufficiency RTOG 0436
Kidney 100% 23 Renal insufficiency RTOG 0436
Kidney 10% 18 20 Renal insufficiency Spalding
Lens 25 Cataracts RTOG 0615
Lens Cataracts Avoid direct beam exposure RTOG 0513
Liver 50% 35 Clinical hepatitis RTOG 0436
Liver 100% 30 Clinical hepatitis RTOG 0436
Lung minus GTV 37% 20 Clinical pneumonitis RTOG 0623
Lung minus GTV Mean 20 Clinical pneumonitis RTOG 0623
Mandible 1 75 70 Use either limit RTOG 0225
Optic nerves 1% 60 54 1% of PTV, use either limit RTOG 0225
Oral cavity (exclude PTV) Mean 40 RTOG 0615
Parotid gland (both) 20 20 Xerostomia Only if sparing both glands RTOG 0912
Parotid gland (one) 50% 30 Xerostomia Only if sparing one gland RTOG 0912
Parotid gland (one) Mean 26 Xerostomia Only if sparing one gland RTOG 0912
Penile bulb Mean 52,5 RTOG 0126
Rectum 15% 75 RTOG 0126
Rectum 25% 70 RTOG 0126
Rectum 35% 65 RTOG 0126
Rectum 50% 60 RTOG 0126
Small bowel 65 45 50 RTOG 0822
Small bowel 100 40 50 RTOG 0822
Small bowel 180 35 50 RTOG 0822
Spinal cord 45 Myelitis RTOG 0623
Spinal cord 0,03 48 Myelitis RTOG 0619
Stomach 2% 50 54 Spalding
Stomach 25% 45 54 Spalding
Temporal lobes 1% 65 60 1% of PTV, use either limit RTOG 0225
Tongue 1% 65 55 1% of PTV, use either limit RTOG 0225

Limits in this table are the default DVH objectives in Mobius3D (http://www.mobiusmed.com/)