Lung · Organ at risk

Great Vessels

Educational Summary

Dose constraints

Lung SBRT

Schedule	Constraint	Source
30–34 Gy / 1 fx Peripheral	Max dose <30 Gy	TROG SAFRON II
54 Gy / 3 fx Peripheral	D0.5 cc <45 Gy	UK SABR Consortium 2019
50 Gy / 5 fx Central	Max dose 52.5 Gy	RTOG 0813
	D10 cc <47 Gy	RTOG 0813

Quoted from eviQ 3389 and eviQ 4018, checked 2026-09-22. Full table with references →

Anatomy

The large arteries and veins entering and leaving the heart — generally the aorta, the superior (and in some definitions inferior) vena cava, and the pulmonary arteries and veins. Which named vessels are contoured, and how far above and below the target, is set by each protocol or table.

Function in the body

The great vessels — the aorta, the venae cavae and the pulmonary arteries and veins — carry blood between the heart, the lungs and the body.

Why it matters

The great vessels matter mainly for central SBRT, where a small vessel segment may receive very high dose. The endpoint listed in the Timmerman 2022 tables is aneurysm. For context on treating tumors near the mediastinum, see RTOG 0813.

How to contour

Timmerman 2022 (Tables 8–11, written for its SBRT dose tables) contours the wall and lumen of the named vessel, at least 10 cm above and below the PTV.

Kong 2011 left the heart and great vessels out of its thoracic atlas because of their complexity. Open published boundaries beyond Timmerman's instruction: verified source required.

Review articleSource Verified

A Story of Hypofractionation and the Table on the Wall

Timmerman R · UT Southwestern Medical Center · 2022

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.

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Contouring atlasUnder Review

Consideration of dose limits for organs at risk of thoracic radiotherapy: atlas for lung, proximal bronchial tree, esophagus, spinal cord, ribs, and brachial plexus

Kong FM, Ritter T, Quint DJ, et al. · 2011

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.

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Related concepts

Maximum Dose

D0.03cc / Near-Max Dose

Dose-Volume Histogram