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Table 1 Dosimetric planning guidelines for breast VMAT

From: Reduction in low-dose to normal tissue with the addition of deep inspiration breath hold (DIBH) to volumetric modulated arc therapy (VMAT) in breast cancer patients with implant reconstruction receiving regional nodal irradiation

Structure Parameter Objective
PTV D95 (%) ≥95%
V95 (%) ≥95%
D05 (%) ≤110%
IMN D95 (%) ≥100%
Ipsilateral Lung V20 Gy (%) ≤33%
V10 Gy (%) ≤68%
Mean (Gy) ≤20Gy
Contralateral Lung V20 Gy (%) ≤8%
Heart V25 Gy ≤25%
Mean (Gy) ≤9Gya; ≤8Gyb
Dmax (Gy) ≤50Gy
LAD Dmax (Gy) ≤50Gy
Contralateral intact breast Mean (Gy) ≤5Gy
Contralateral implant Mean (Gy) ≤8Gy
Esophagus Dmax (Gy) ≤50Gy
Thyroid Mean (Gy) ≤20Gy
Brachial Plexus Dmax (Gy) ≤55Gy
  1. aIf IMN D95 ≥ 100%
  2. bIf IMN D95 ≥ 90%