| Schedule | Constraint | Source |
|---|---|---|
| 42–54 Gy / 3 fx Liver metastases | D0.5 cc ≤37 Gy | LARK (TROG 17.03) |
| V30 Gy <30 cc | Dunlap 2010 | |
| 27.5–60 Gy / 5 fx HCC or metastases | D0.5 cc ≤39 Gy | LARK (TROG 17.03) |
| V30 Gy <30 cc | Dunlap 2010 |
Should not compromise target coverage.
Quoted from eviQ 4026, checked 2026-09-29. Full table with references →
The ribs, intercostal muscles, nerves and vessels, and the soft tissue of the thoracic wall surrounding the lungs.
The ribs, intercostal muscles and soft tissue of the chest wall protect the heart and lungs and move with each breath.
The chest wall is the typical limiting structure for peripheral lung SBRT and for liver SBRT of tumors near the rib cage, where the tumor often touches the pleura. Endpoints are chest-wall pain and rib fracture. Because the target frequently abuts the chest wall, trade-offs between target coverage and chest-wall dose are a common planning discussion.
Kong 2011 builds the ribs/chest wall structure automatically:
For the upper abdomen, Jabbour 2014 makes the chest wall the same way from the liver and lung (a 2 cm expansion front, back and side), including the ribs and chest wall soft tissue and excluding the sternum and vertebral bodies.
"Chest wall" and "rib" are different structures and sources use different ones: Timmerman 2022 lists a "Rib" row in its 1–8 fraction tables. A limit only applies to the structure it was written for.
A thoracic organ-at-risk contouring atlas with discussion of dose limits, covering the lung, proximal bronchial tree, esophagus, spinal cord, ribs and brachial plexus. A published letter in response discusses esophageal delineation.
RTOG consensus guidelines and atlas for delineating upper abdominal normal organs. Citation checked against Europe PMC.
An editorial history of the UT Southwestern SABR constraint tables — often called the “Timmerman tables” — covering how they were developed and revised, and their relationship to AAPM TG-101 and NRG/RTOG protocols. Tables 2–11 separate serial tissues (listed with a volume, a volume max and a max point dose) from parallel tissues (listed with a critical volume and a critical-volume dose max). In Tables 2–7 a footnote defines “point” as ≤0.035 cm³; Tables 8–11 add a contouring-instructions column for each structure.