| Schedule | Constraint | Source |
|---|---|---|
| 60 Gy / 20 fx Moderate hypofractionation | V48.6 Gy <25% | CHHiP (Dearnaley 2016), CHHiP PROs (Wilkins 2015) |
| V60 Gy <5% | CHHiP (Dearnaley 2016), CHHiP PROs (Wilkins 2015) | |
| 70 Gy / 28 fx Moderate hypofractionation | V70 Gy ≤15% | ASTRO DVH Compendium 2026 |
| V65 Gy ≤25% | ASTRO DVH Compendium 2026 | |
| V40 Gy ≤65% | ASTRO DVH Compendium 2026 | |
| 78–80 Gy / 39–40 fx Conventional | V65 Gy <50% | ENZARAD protocol, QUANTEC |
| V70 Gy <35% | ENZARAD protocol, QUANTEC |
Quoted from eviQ 234 and ASTRO DVH Compendium 2026, checked 2026-10-14. Full table with references →
| Schedule | Constraint | Source |
|---|---|---|
| 60 Gy / 20 fx Nodes 44 Gy | V48.6 Gy <25% | CHHiP (Dearnaley 2016), CHHiP PROs (Wilkins 2015) |
| V60 Gy <5% | CHHiP (Dearnaley 2016), CHHiP PROs (Wilkins 2015) | |
| 68 Gy / 25 fx Nodes 45–50 Gy | V50 Gy <25% | POP-RT (toxicity) |
| V60 Gy <15% | POP-RT (toxicity) | |
| 78–80 Gy / 39–40 fx Nodes 54–60 Gy | V65 Gy <50% | ENZARAD protocol, QUANTEC |
| V70 Gy <35% | ENZARAD protocol, QUANTEC |
Quoted from eviQ 3657, checked 2026-09-23. Full table with references →
| Schedule | Constraint | Source |
|---|---|---|
| 36.25 Gy / 5 fx To PTV (40 Gy to CTV) | V37 Gy ≤5 cc (ideal), ≤10 cc (acceptable) | PACE-B |
| V18.1 Gy ≤40% | King 2012 |
Quoted from eviQ 4140, checked 2026-09-22. Full table with references →
| Schedule | Constraint | Source |
|---|---|---|
| 64–66 Gy / 32–33 fx 2 Gy per fraction | V65 Gy <50% | ENZARAD protocol, QUANTEC |
| V70 Gy <35% | ENZARAD protocol, QUANTEC | |
| 52.5 Gy / 20 fx 2.63 Gy per fraction | V40 Gy <80% | RADICALS-HD |
| V48 Gy <50% | RADICALS-HD |
Quoted from eviQ 4487, checked 2026-09-22. Full table with references →
A hollow muscular organ that sits in front of the rectum and directly above the prostate. The bladder base and neck rest on the prostate, and the bladder's shape and position change considerably with filling.
The bladder stores urine until it is passed.
Bladder dose is linked to urinary side effects — frequency, urgency, dysuria and, later, bleeding or reduced capacity. As with the rectum, limits are written as a ladder of volume thresholds, and they depend heavily on how full the bladder is: a fuller bladder pushes more of its wall (and often small bowel) away from the high-dose region. That is why simulation instructions usually ask for a comfortably full bladder and why reproducing it each day matters.
In rectal and anal cancer the bladder lies in front of the mesorectal and nodal volumes. Where it overlaps the target, a maximum-dose limit may not be achievable; one rectal protocol then suggests minimizing the bladder volume above 50 Gy instead.
In gynecologic treatment the bladder sits in front of the cervix and vagina, and its filling moves the uterus and vaginal cuff — the reason GYN simulations often scan with a full and an empty bladder to build an internal target volume. In cervix brachytherapy the bladder D2cc, in EQD2 with the external beam dose, is a planning limit, and a Foley catheter balloon marks the bladder base.
Bladder filling changes the volume a lot, so follow your protocol's filling instructions.
RTOG consensus panel atlas of male and female pelvic normal tissues. Citation as given in the eviQ reference list; not yet checked against the journal.
The template NRG Oncology gives investigators for writing the radiation therapy section of an anal cancer trial. Its example text and values are based on RTOG 0529 and the ECOG-ACRIN DECREASE trial (EA2182), and are meant to be edited for each protocol. It covers immobilization (a supine "frog-leg" position is recommended), CT or PET/CT simulation, rigid registration of MRI and PET to the planning CT, standard structure names, dose compliance tables and planning priorities.
An editorial history of the UT Southwestern SABR constraint tables — often called the “Timmerman tables” — covering how they were developed and revised, and their relationship to AAPM TG-101 and NRG/RTOG protocols. Tables 2–11 separate serial tissues (listed with a volume, a volume max and a max point dose) from parallel tissues (listed with a critical volume and a critical-volume dose max). In Tables 2–7 a footnote defines “point” as ≤0.035 cm³; Tables 8–11 add a contouring-instructions column for each structure.