The dose constraints are the result of quality measure development between the VA and ASTRO. They represent the body of work thus far, with the goal of expanding future resources to include other disease sites. There is still work to be done to optimize dose goals and constraints for target volumes and normal tissues. Different methodologies for calculating doses have produced varying data, and ongoing efforts will harmonize the lack of concordance where possible. Wide variation when reporting on toxicities and efforts to standardize provide an opportunity for future trial data to add to the depth of knowledge. This DVH compendium is pragmatic and reflective of general practice and established treatment regimens. Having accessible default constraints supports standardization and will help improve the quality of treatment planning and radiation delivery for all patients.
Puckett et al. (Thu,) studied this question.