GOECP/SEOR clinical guidelines on radiotherapy for malignant pleural mesothelioma

Table 5 Dose constraints in organs at risk

Organs at risk	Dose constraints
Lungs-GTV	V20 < 37%, Mean dose < 20 Gy
Contralateral lung-PTV	V20 < 20%, V5 < 17%, Mean dose < 8 Gy
Ipsilateral lung	V40 < 67%, Mean dose < 36 Gy
Heart defined as pericardial sac	Right mesothelioma V40 < 25%; Left mesothelioma V40 < 35%
Brachial plexus	Maximum dose < 65 Gy
Esophagus	V55 Gy < 30%; Mean dose < 34 Gy
Stomach minus including PTV	Mean dose < 30 Gy
Bowel	Maximum dose < maximum PTV < 55 Gy; D5 cc < 50 Gy
Spinal cord	Maximum dose < 50 Gy
Liver minus GTV	V30 < 45%; Mean dose < 30 Gy
Kidneys evaluated separately	V18 < 33% (or V18 < 50%, if cannot be achieved at ≤ 33%)
Ipsilateral kidney; Contralateral kidney	V25 < 40%; V10 < 10%

GTV: Gross tumor volume; PTV: Planning treatment volume; V: Percent volume of organ permitted to receive specified dose.