Table 1.

Institutional planning criteria for VMAT/IMRT Breast/Chestwall. Quantities in parentheses are the highest permitted without special physician consideration.

Target Criteria					Note
PTV	D95%	≥	95%
	D05%	≤	115%		Inside Implant D05<=120%
IMN PTV	D95%	≥	100%		IMN D95%≥90% only if OK with MD and if it helps reduce Heart Mean Dose
Normal Tissue Criteria
			Ideal (Acceptable)
			Non DIBH	DIBH
Ipsilateral Lung	V20Gy	≤	30% (33%)	27% (30%)
	V10Gy	≤	65% (68%)	60% (63%)
	Mean Dose	≤	18Gy	18Gy
Contralateral Lung	V20Gy	≤	5%
Heart	V25Gy	≤	3%		If Left Sided
		≤	0.5%		If Right Sided
	Max. Point Dose	≤	50Gy
	Mean Dose	≤	7Gy(8Gy)	6Gy(7Gy)	If Left Sided and IMN D95%>=90%
		≤	4Gy		If Right Sided and IMN D95%>=90%
		≤	10Gy		If Left Sided and IMN D95%>=100%
		≤	5Gy		If Right Sided and IMN D95%>=100%
Left Anterior descending Artery	Max. Point Dose	≤	25Gy(35Gy)
Thyroid	Mean Dose	≤	20 Gy
Esophagus	Max Point Dose	≤	35 Gy(40Gy)
Ipsilateral Brachial Plexus	Max. Point Dose	≤	55Gy
Contralateral Intact Breast	Mean Dose	≤	6Gy
Contralateral Implant	Mean Dose	≤	8Gy
Liver	Mean Dose	≤	8Gy (10Gy)		For Right Sided
Stomach	Mean Dose	≤	5Gy	3Gy	For Left Sided
Cord	Max Point Dose	≤	20Gy