Top Line: Who couldn’t use a solid sanity check to confirm the safety of a fractionation scheme that just feels right.
The Study: ASTRO, in partnership with the VA National Radiation Oncology Program, has published a comprehensive dose-volume histogram compendium synthesizing dose constraints across six major disease sites (breast, head & neck, liver, lung, prostate, rectum). Drawing from prior VA/ASTRO quality initiatives, multisite clinical trial protocols, and expert consensus, disease-site panels developed pragmatic, regimen-specific dose constraint tables spanning conventional to ultra-hypofractionation. Constraints were vetted using a modified Delphi process, requiring ≥75% agreement for inclusion, with explicit categorization into primary goals (green), secondary goals (yellow), and deviations (red). Where data were sparse, panel consensus filled the gaps; where organs behave as parallel structures, complementary volume (CV) metrics were emphasized to reflect modern planning reality.
TBL: This provides an excellent planning support tool, designed to harmonize practice variation without handcuffing clinical judgment, and can be cross-referenced with other user-friendly tools such as RadOncCalc. | Puckett, Pract Radiat Oncol 2026
The Study: ASTRO, in partnership with the VA National Radiation Oncology Program, has published a comprehensive dose-volume histogram compendium synthesizing dose constraints across six major disease sites (breast, head & neck, liver, lung, prostate, rectum). Drawing from prior VA/ASTRO quality initiatives, multisite clinical trial protocols, and expert consensus, disease-site panels developed pragmatic, regimen-specific dose constraint tables spanning conventional to ultra-hypofractionation. Constraints were vetted using a modified Delphi process, requiring ≥75% agreement for inclusion, with explicit categorization into primary goals (green), secondary goals (yellow), and deviations (red). Where data were sparse, panel consensus filled the gaps; where organs behave as parallel structures, complementary volume (CV) metrics were emphasized to reflect modern planning reality.
TBL: This provides an excellent planning support tool, designed to harmonize practice variation without handcuffing clinical judgment, and can be cross-referenced with other user-friendly tools such as RadOncCalc. | Puckett, Pract Radiat Oncol 2026