Table 2:

Sections within each organ-specific report (OSR)

Required Sections	Content
Anatomy & developmental dynamics	•Define anatomy as it impacts normal tissue damage •Describe anatomic and physiologic development according to age as it impacts organ sensitivity to damage and repair
Clinical significance	•Describe the clinical situations where the organ is irradiated •Describe the frequency, characteristics, significance of injury
Endpoints & toxicity scoring	•Address strengths and limitations of existing systems •Recommend how to score organ injury •Describe the different endpoints often considered when assessing injury •Describe the time course of organ injury
Challenges defining volumes: pediatric imaging issues	•Describe recommended imaging modality and acquisition methods •Discuss the impact of intra-/inter-fractional organ movement or volume change during the course of treatment •Discuss the need for contouring planning organ-at risk volumes (PRV) •Note normal organ contouring atlases or reference existing publically available atlases.
Review of dose volume response data/risk factors	•Review of dose-volume data: For each organ (tissue), published data on toxicity risks as correlated with dosimetric parameters and other relevant variables (i.e. age, developmental status), are reviewed. From the available data, meaningful dose/volume limits with associated risk rates are presented. Include data on various dose fractionations, adequacy, quality, and bias. •Dose Volume Endpoints:  --Organ Function: Lab/subclinical endpoints, imaging endpoints, physiologic/functional issues  --Organ Development: Impact of age  --Second malignant neoplasms: volume, dose •Risk Factors: genetic predispositions, gender, race, age, co-medical conditions •Chemotherapy/Combined modality: Relevant chemotherapy data impacting radiation sensitivity •Mathematical/Biologic models + Epidemiologic issues: For each organ, models that have been used to relate dose/volume data to normal tissue complications and second malignancies in the organ are summarized, along with associated model parameters, limitations and uncertainties.
	•Recommended Dose/Volume Limits- The available information is condensed into meaningful dose/volume limits, with associated risk rates, for clinical application. Limits are according to endpoints and age. •Level of evidence: specify for each report •Special situations: situations where the presented data/models may not apply (e.g. hypofractionation)
Toxicity scoring recommendations	•Recommendations on how to score organ injury and toxicities.
Interventions and Management
Contrast Pediatric & Adult NTCP data
Future Investigations	•Describes areas in need of future study