Dose-Volume Histogram Compendium of Dose Constraints for Treatment Planning: An ASTRO Consensus Paper.

Area of Science:

• Radiation Oncology
• Medical Physics

Background:

• Quality surveillance in radiation therapy is crucial for optimizing patient outcomes.
• The Veterans Affairs (VA) and American Society for Radiation Oncology (ASTRO) collaborated to develop performance indicators.
• Dose-volume histogram (DVH) metrics are essential for dosimetric treatment planning.

Purpose of the Study:

• To create a DVH compendium for common cancer sites (breast, head and neck, liver, lung, prostate, rectal).
• To provide guidance for physician decision-making in radiation therapy planning.
• To support the evolution of DVH metrics in external beam radiation therapy.

Main Methods:

• Developed DVH tables for common dose/fractionation regimens.
• Prioritized dosimetric values with clinical data validation and use in multisite trials.
• Utilized a modified Delphi approach with ≥75% consensus for clinical guidance and metric agreement.

Main Results:

• Established dose constraints as a result of VA/ASTRO quality measure development.
• The compendium reflects current general practice and established treatment regimens.
• Accessible default constraints aim to standardize treatment planning and improve radiation delivery.

Conclusions:

• The DVH compendium serves as a foundational resource for radiation therapy quality.
• Further research is needed to optimize dose goals and constraints for various cancer sites.
• Standardization of DVH metrics and toxicity reporting will enhance future clinical trial data and knowledge depth.