A thoracic organ-at-risk contouring atlas with discussion of dose limits, covering the lung, proximal bronchial tree, esophagus, spinal cord, ribs and brachial plexus. A published letter in response discusses esophageal delineation.
Contralateral Lung
Dose constraints
Whole Breast
| Schedule | Constraint | Source |
|---|---|---|
| 40.05 Gy / 15 fx or 42.56 Gy / 16 fx | V5 Gy <10% | eviQ 3650 |
Quoted from eviQ 3650, checked 2026-09-23. Full table with references →
Partial Breast
| Schedule | Constraint | Source |
|---|---|---|
| All schedules 40.05 Gy/15 fx · 30 Gy/5 fx · 26 Gy/5 fx | V10% ≤5% (ideal) | ASTRO PBI 2023 |
| V5% ≤15% (acceptable) | ASTRO PBI 2023 |
Quoted from eviQ 3658, checked 2026-09-23. Full table with references →
Post-Mastectomy Chest Wall
| Schedule | Constraint | Source |
|---|---|---|
| 50 Gy / 25 fx | V5 Gy <10% | eviQ 1925 |
Quoted from eviQ 1925, checked 2026-09-23. Full table with references →
Regional Nodal Irradiation
| Schedule | Constraint | Source |
|---|---|---|
| 45–50 Gy / 25 fx 1.8–2 Gy per fraction | V5 Gy <10% | eviQ 1924 |
Quoted from eviQ 1924, checked 2026-09-23. Full table with references →
Anatomy
The lung on the opposite side from the treated breast or chest wall.
Why it matters
With well-placed tangents the contralateral lung gets very little dose. Its limit is a low-dose metric — a small volume allowed to receive a few gray — because it mainly catches low-dose spread from IMRT, VMAT or beams that enter from the opposite side.
How to contour
Contour the whole opposite lung; it is evaluated on its own, not combined with the ipsilateral lung. The Kong thoracic atlas covers lung contouring.