2.0 f15bc774-b554-4624-a2ef-188bc9e7fbab *AOS_Lung_R conv fx 66Gy 33fx v1 Thorax Lung Right *AOS_Lung_R conv fx 66Gy 33fx AOS sample template - to be copied, reviewed, modified as deemed appropriate, and approved by site physicist Summary: 33 fx right lung conventional fx to 66 Gy References: ARTIA-Lung, "Daily Adaptive Radiation Therapy: An Individualized Approach for Stage III Lung Cancer (ARTIA-Lung)"; RTOG 1306, "A Randomized Phase II Study of Individualized Combined Modality Therapy for Stage III Non-Small Cell Lung Cancer (NSCLC)" Version 1.0 Created: 6/13/2025 PHH ********************************************************************* Target Contouring: "The gross tumor volume of the primary tumor is contoured on the averaged phases of the 4-D CT that will be used for treatment. The internal gross tumor volume of the primary tumor is the union of the primary GTVs on all contoured phases. Post-processed 4-D CT images such as the maximal intensity projection can be utilized to aid in defining the IGTVp. The IGTVp may be modified as deemed necessary based on co-registered PET and other imaging studies." - ARTIA Lung Target Margins: "The clinical target volume of the primary tumor is defined to account for subclinical extension of primary tumor beyond what is visible on imaging studies. The CTVp will consist of a 5mm margin around the IGTVp (CTVp=IGTVp+5mm) without extending into uninvolved organs such as heart, esophagus, and bone." - ARTIA Lung "The planning target volume is defined to account for uncertainties in patient positioning and treatment delivery for the primary tumor. The planning target volume is a 3mm isotropic expansion around the CTVp." - ARTIA Lung OAR Contouring: See ARTIA-Lung Table 9 in Appendix A further OAR contouring information. OAR Constraints: Lungs-GTV V20Gy[%] ≤33% ≤37% V5Gy[%] ≤60% ≤65% Mean[Gy] ≤20 Gy ≤22 Gy Esophagus D0.03cc[Gy] ≤63 Gy ≤66 Gy Mean[Gy] ≤34 Gy ≤40 Gy Heart V30Gy[%] ≤50% ≤55% V45Gy[%] ≤35% ≤40% Spinal Cord D0.03cc[Gy] ≤48 Gy ≤50 Gy Brachial Plexus right or Brachial Plexus left D0.03cc[Gy] ≤66 Gy >66 Gy. ** Additional OAR contraints and objectives are based on clinical judgment. Structures have been named according to TG 263 as opposed to the DICOM Standard recommended by RTOG 1306. 5018 FMA 3.2 Bones 4289396157 Bones 7088 FMA 3.2 Heart 4294957055 Heart 7131 FMA 3.2 Esophagus 4289068874 Esophagus 7309 FMA 3.2 Lung right 4278190284 Lung_R 7310 FMA 3.2 Lung left 4294967040 Lung_L 45245 FMA 3.2 Brachial plexus left 4294934720 BrachialPlex_L 45244 FMA 3.2 Brachial plexus right 4286578943 BrachialPlex_R T-D3219 SRT Great vessels of the heart 4291454208 GreatVes 7394 FMA 3.2 Trachea 4278190335 Trachea 264793 FMA 3.2 Set of left ribs 4278223103 Ribs_L 264792 FMA 3.2 Set of right ribs 4291624908 Ribs_R 7163 FMA 3.2 Skin 4286644096 Skin Body BODY 99VMS_STRUCTCODE 1.0 Body plus other external items 5 0 ]]> 7148 FMA 3.2 Stomach 4294934720 Stomach 9869 FMA 3.2 Pericardium 4294901888 Pericardium 7197 FMA 3.2 Liver 4278206464 Liver 7405 FMA 3.2 Main bronchus 4289986559 Bronchus_Main 68877 FMA 3.2 Both lungs 4294934528 Lungs 7647 FMA 3.2 Spinal cord 4278255615 SpinalCord GTVp 99VMS_STRUCTCODE 1.0 Primary gross tumor volume 4285868492 GTV ITV 99VMS_STRUCTCODE 1.0 Internal target volume 4294934528 ITV R-429EC SRT Planning target volume 4294901760 PTV Target2 ITV 99VMS_STRUCTCODE 1.0 Internal target volume 3 Body BODY 99VMS_STRUCTCODE 1.0 Body plus other external items -2 ]]> R-429EB SRT Clinical target volume 4280918220 CTV Target1 GTVp 99VMS_STRUCTCODE 1.0 Primary gross tumor volume 5 ]]> HealthyTissue 99VMS_STRUCTCODE 1.0 Generic healthy tissue 4278933393 Lungs-GTV OAR5 7310 FMA 3.2 Lung left OAR4 7309 FMA 3.2 Lung right Target1 GTVp 99VMS_STRUCTCODE 1.0 Primary gross tumor volume ]]> Target3 2 VolumeDose ShouldBeMoreOrEqual 95 Relative 66 Absolute VolumeDose ShouldBeMoreOrEqual 90 Relative 66 Absolute 1 1 DoseVolume ShouldBeMoreOrEqual 99 Relative 61.6 Absolute DoseVolume ShouldBeMoreOrEqual 99 Relative 59.4 Absolute 2 1 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 110.00000000000001 Relative DoseVolume ShouldBeLessOrEqual 0.03 Absolute 115.00000000000001 Relative 2 7 OAR3 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 63 Absolute DoseVolume ShouldBeLessOrEqual 0.03 Absolute 66 Absolute 4 1 OAR3 MeanDose ShouldBeLessOrEqual 34 Absolute MeanDose ShouldBeLessOrEqual 40 Absolute 2 3 OAR6 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 66 Absolute 3 8 OAR7 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 66 Absolute 3 9 OAR2 VolumeDose ShouldBeLessOrEqual 50 Relative 30 Absolute VolumeDose ShouldBeLessOrEqual 55.00000000000001 Relative 30 Absolute 2 4 OAR2 MeanDose OAR2 VolumeDose ShouldBeLessOrEqual 35 Relative 45 Absolute VolumeDose ShouldBeLessOrEqual 40 Relative 45 Absolute 3 OAR8 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 66 Absolute 3 4 OAR8 VolumeDose ShouldBeLessOrEqual 10 Absolute 45 Absolute 3 1 OAR9 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 66 Absolute 3 6 OAR11 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 66 Absolute DoseVolume ShouldBeLessOrEqual 0.03 Absolute 66 Absolute 4 3 OAR10 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 66 Absolute DoseVolume ShouldBeLessOrEqual 0.03 Absolute 66 Absolute 4 4 OAR12 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 55 Absolute DoseVolume ShouldBeLessOrEqual 0.03 Absolute 60 Absolute 4 5 OAR12 DoseVolume ShouldBeLessOrEqual 10 Absolute 49 Absolute DoseVolume ShouldBeLessOrEqual 10 Absolute 54 Absolute 4 6 OAR14 VolumeDose ShouldBeLessOrEqual 50 Relative 30 Absolute VolumeDose ShouldBeLessOrEqual 55.00000000000001 Relative 30 Absolute 2 5 OAR14 MeanDose OAR14 VolumeDose ShouldBeLessOrEqual 35 Relative 45 Absolute VolumeDose ShouldBeLessOrEqual 40 Relative 45 Absolute 3 OAR13 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 45 Absolute 4 2 OAR15 DoseVolume ShouldBeLessOrEqual 700 Absolute 25 Absolute 3 7 OAR15 MeanDose OAR16 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 66 Absolute 3 5 ControlRegion1 MeanDose ShouldBeLessOrEqual 20 Absolute MeanDose ShouldBeLessOrEqual 22 Absolute 2 2 ControlRegion1 VolumeDose ShouldBeLessOrEqual 33 Relative 20 Absolute VolumeDose ShouldBeLessOrEqual 37 Relative 20 Absolute 2 6 ControlRegion1 VolumeDose ShouldBeLessOrEqual 60 Relative 5 Absolute VolumeDose ShouldBeLessOrEqual 65 Relative 5 Absolute 2 OAR18 DoseVolume ShouldBeLessOrEqual 0.03 Absolute 48 Absolute DoseVolume ShouldBeLessOrEqual 0.03 Absolute 50 Absolute 1 2 NoNormalization 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None 1 None