Table 1.

QUantitave Analysis of Normal Tissue Effects in fhe Clinic (QUANTEC) recommendations for dose constraints during external beam radiation therapy (RT) to the liver.

	Liver metastases	Primary Liver cancer	comment
Whole liver RT	≤ 30 Gy, 2 Gy/F 21 Gy/7 F	≤28 Gy, 2 Gy/F 21 Gy/7 F	Whole organ prescription dose
Partial liver RT, conventional fractionation	≤ 32 Gy	≤ 28 Gy	Mean normal liver* dose for tumor dose ≤ 2 Gy/F
SBRT, 3–6 F	< 15 Gy/3F < 20 Gy/6 F	< 13 Gy/3F < 18 Gy/6F CP B: < 6 Gy/4-6F	Mean normal liver* dose
	At least 700 cc normal liver < 15 Gy/3F		Critical volume model
	At least 800 cc normal liver < 18 Gy/3F		Only for Child-Pugh class A

^*Normal liver refers to the total volume of liver minus the gross tumor volume.

SBRT = Stereotactic body radiation therapy; F = fraction; GTV = gross tumor volume; CP = Chld-Pugh class. Modified from Pan et al [17].