Topics:
Head and Neck Cancers • Radiation Oncology
What volumetric dose constraints, if any, do you use for the mandible in the definitive setting for H&N cancers?
Are there certain portions of the mandible that you constrain more than others?
Answer from: Radiation Oncologist at Community Practice
Agree, tumor coverage in definitive setting is first priority.
We use mandible constraints below:
Mandible D0.03cc
No tumor overlap with PTV: <70 Gy
Tumor overlap with PTV: <73.5 Gy
Multiple studies recommend minimizing mandible volume >50 Gy to >60 Gy, but I...
Sign in or Register to read more
Answer from: Radiation Oncologist at Academic Institution
The planning directions for the mandible are typically <50 Gy. However, when the targets are adjacent to the mandible we do not constrain the maximal mandibular dose if it may compromise target dose. In that case, we plan a dose gradient across the mandible, with the mucosa and inner plate of the...
Comments
Radiation Oncologist at Northeast Oklahoma Cancer Center
Is there good data to support any given constraint...
Is there good data to support any given constraint...
Radiation Oncologist at MNAP Medical Solutions
"The worst complication is failure to control the ...
"The worst complication is failure to control the ...
Answer from: Radiation Oncologist at Academic Institution
We use four constraints for the mandible, all prioritized secondary to target coverage:
D0.03cc < 73.5Gy
V70Gy < 5cc
V58Gy < 25%
V44Gy < 42%
We have not incorporated the D30% values from the NTCP model (at least not yet). But I think the dose-response relationship depicted by this m...