Dose to sites Flashcards
Skin
Temp alopaecia 10-15Gy
Faint erythema 14-16Gy
Erythema 20Gy
Dry desquimation 30Gy
Moist Desquimation 40Gy
Permanent alopecia 50Gy
Chronic Telangiectasia TD 5/5: 50Gy to 100cm^2 occurs 1-2yrs post RT
Endpoint: Gangrene, necrosis, and ulceration
55Gy to 100cm^2 leads to endpoint reaction months to years post-treatment. Smaller fields, such as 10cm^2 can tolerate up to 60-70Gy
Cartilage
70Gy causes cartilage necrosis months to years post-treatment due to vascular damage
Femoral Heads and Necks
TD 50Gy < 50% of volume can cause osteoradionecrosis years to decades after RT
Small Bowel
Enteritis 20-25Gy
Diarrhoea 25Gy
Constipation 25Gy
QUANTEC: the volume receiving 45Gy should be less than 195cc for a less than 10% chance of RTOG Grade 3+ toxicity years to months post-treatment
Endpoint: Necrosis, Perforation, and Fistula
Bladder
Cystitis, Dysuria, and increased frequency 25Gy
Endpoint: Bladder contracture and volume loss
QUANTEC: A maximum radiation dose of less than 65GY to the whole organ creates a less than 6% chance of Grade 3 late RTOG endpoint months to years post-treatment. Which is severe frequency, dysuria, severe telangiectasia, and frequent haematuria.
Rectum
Acute: 20-25Gy
Proctitis
Haematochesia
Diarrhoea
Dyschesia
Rectal Pain
QUANTEC: V50<50%, V60<35%, V65<25%
less than 10% chance of a RTOG grade 2/3 late rectal toxicity months to years post-treatment
Grade 3: Obstruction or bleeding
Endpoint: Severe proctitis, fistula, stenosis, necrosis
Anus
Acute:
Inflammation and moist desquamation of the skin
Endpoint: Chronic ulcers, loss of sphincter function, and stenosis
Penile Bulb
QUANTEC: 50Gy to 90% of the gland creates a less than 35% chance of severe erectile dysfunction months to years post-treatment
Ovaries
Acute: Persistent amenorrhea 2Gy
Endpoints: Permanent sterility 2.5Gy
Vagina
Acute:
Vaginal adhesions 10Gy
Vaginitis 30Gy
Endpoint: Ulcer, fistula, fibrosis
120Gy - upper vagina
80-90Gy mid vagina
60Gy to lower 1/3
Testes
Acute: transient aspermia 0.5Gy
Endpoint: Permanent sterility 1.5Gy
Stomach
Acute: Gastritis 10-20Gy
QUANTEC: 45Gy to the whole organ for a less than 7% chance of ulceration, mucosal erosion, and perforation months to years post-treatment
Kidneys
QUANTEC: For bilateral kidneys the volume receiving 28Gy should be less than 20% this creates less than 5% chance of clinical dysfunction months to years post-treatment
Endpoint: Nephritis and kidney failure
Liver
Acute:
Jaundice, Anorexia, and Fatigue 20-25Gy
Acute radiation hepatitis and ascites 25Gy
Endpoint:
Veno-occulsive disease
Radiation-induced liver disease for which there is a less than 5% chance of occurring 2-3 weeks post-treatment if the liver is partially irradiated to 30-32Gy
Spleen
Acute: Blood counts altered and poor immune function 30-40Gy