Radiation Associated Brainstem Injury

Comparison of selected data on brainstem tolerance and dose constrains compared to linear quadratic (LQ) model extrapolations. Data points are marked with the corresponding author and dose parameter considered in parenthesis (e.g., surface or maximum dose). Center, 0.9 mL, 0.1 mL, and 3 mL refer to the minimum dose to that hottest volume. Some data were estimated from the cited articles. Cut points illustrate thresholds determined by authors to correlate with significant increase in incidence of brainstem necrosis or neuropathy. Little quantitative data on brainstem doses is available in the dose range of stereotactic radiosurgery and hypofractionation. BID = twice daily; BS = Brain Stem; Dmax = maximum dosage.