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The healthy organs near a tumour that limit how much dose can be given, each with a maximum dose or dose-volume limit the plan must respect (for example, keeping the spinal cord below about 45 to 50 Gy).
Every plan trades tumour dose against the tolerance of nearby organs: spinal cord, brainstem, optic nerves, lungs, heart, kidneys, rectum and bladder among them. Dose constraints come from decades of outcome data, summarised in the QUANTEC reviews and, for stereotactic treatment, HyTEC, and are expressed as maximum point doses or the volume allowed above a threshold. Meeting the constraints is what the optimiser and the planner negotiate.
Showing the technology this term belongs to: IMRT / IGRT (modern external beam).
The clearest randomised evidence that putting more dose where imaging shows the tumour, rather than spreading it evenly, improves control. It depends on seeing and outlining the lesion on MRI, and on respecting the limits of the bladder and rectum first.
Variation between clinicians in drawing the target is one of the largest errors in radiotherapy and one of the least measured in terms of what it does to patients. The field has studied whether outlines differ far more than whether the differences matter.
Shares Adaptive radiotherapy (online replanning), Radiotherapy treatment planning and QA software and the tag radiation-wave1.
Shares C-arm medical linear accelerators (TrueBeam, Versa HD and others), IMRT / IGRT (modern external beam) and the tag radiation-wave1.
Shares Tumour control and normal tissue complication probability (TCP and NTCP) and the tag radiation-wave1.
Shares Tumour control and normal tissue complication probability (TCP and NTCP), IMRT / IGRT (modern external beam) and the tag radiation-wave1.
Shares Radiotherapy treatment planning and QA software, IMRT / IGRT (modern external beam) and the tag radiation-wave1.
Shares C-arm medical linear accelerators (TrueBeam, Versa HD and others) and the tag radiation-wave1.
Shares RTOG 0617, IMRT / IGRT (modern external beam) and the tag radiation-wave1.
Shares Uncertainties in volume delineation in radiation oncology: a systematic review and recommendations for future studies, Volumetric modulated arc therapy (VMAT), Variation between clinicians in drawing the radiotherapy target, Adaptive radiotherapy (online replanning) and the tag radiation-wave1.