Organs at risk radiation dose constraints: 2025 update

Area of Science:

• Radiation Oncology
• Medical Physics
• Clinical Decision Support

Background:

• Existing radiation dose constraints for organs at risk lack harmonization.
• Current constraints are often based on older radiotherapy techniques, necessitating adaptation for modern methods.
• Advanced radiotherapy techniques like IMRT and SBRT require updated dose guidelines.

Purpose of the Study:

• To provide updated, unified radiation dose constraints for organs at risk in adult patients.
• To support clinical decision-making in contemporary radiotherapy practice.
• To minimize the risk of normal tissue toxicity in radiotherapy.

Main Methods:

• Consensus-based update of recommendations from the Société française de radiothérapie oncologique (SFRO).
• Inclusion of various clinical scenarios: normofractionation, hypofractionation, stereotactic radiotherapy, and reirradiation.
• Adaptation of existing knowledge for modern radiotherapy techniques.

Main Results:

• A comprehensive framework of updated radiation dose constraints for organs at risk.
• Guidelines applicable to a wide range of radiotherapy techniques and clinical scenarios.
• Emphasis on the crucial role of clinical judgment, especially in complex cases.

Conclusions:

• The updated SFRO recommendations offer a practical, evidence-based tool for radiation oncologists and medical physicists.
• These guidelines facilitate safer and more effective radiotherapy by addressing modern techniques.
• Harmonized dose constraints are essential for consistent and optimal patient care in radiation oncology.