RTOG Protocol 0522

Plan Scoring for IMRT

PTV70 Scoring
No Variation	Minor Variation	Major Variation
95% of PTVHD is at, or above 70 Gy and	95% of PTVHD is at, or above 70 Gy and	Failure to achieve either No Variation or Minor Variation
99% of PTVHD is at, or above 65.1 Gy and	97% of PTVHD is at, or above 65.1 Gy and
No more than 20% of PTVHD is at, or above 77.0 Gy and	No more than 40% of PTVHD is at, or above 77.0 Gy and
No more than 5% of PTVHD is at or above 80 Gy	No more than 20% of PTVHD is at or above 80 Gy

PTV56 Scoring
No Variation	Minor Variation	Major Variation
95% of PTVLD is at, or above 56 Gy and	95% of PTVLD is at, or above 56 Gy and	Failure to achieve either No Variation or Minor Variation
99% of PTVLD is at, or above 52.0 Gy and	97% of PTVLD is at, or above 52.0 Gy and
No more than 20% of PTVLD is at, or above 61.6 Gy and	No more than 40% of PTVLD is at, or above 61.6 Gy and
No more than 5% of PTVLD is at or above 64.4 Gy	No more than 20% of PTVLD is at or above 64.4 Gy

Parotid Doses

These are goals when using IMRT

Mean dose to either parotid is less than 26.0 Gy or

50% of either parotid receives less than, or equal to 30.0 Gy or

20 cc of the combined parotid glands receive less than 20.0 Gy

Organs at Risk (OAR)

Specific tolerance dose values have been established for this protocol.  While exceeding these dose values is not prohibited, it is strongly recommended that they not be exceeded.

Organ at Risk (OAR)	Dose Limit and Criteria
Glottic Larynx	<45 Gy
Brainstem	54.0 Gy
Spinal Cord	45.0 Gy
Spinal Cord PRV (0.5 cm margin)	No more than 1 cc > 50 Gy
Brachial Plexus	< 60 Gy
Non Target Tissues	< 5% > 70 Gy

W. Straube

5/11/06