PURPOSE: For unbiased comparison of different radiation modalities and techniques, consensus on delineation of radiation sensitive organs at risk (OARs) and on their dose constraints is warranted. Following the publication of a digital, online atlas for OAR delineation in neuro-oncology by the same group, we assessed the brain OAR-dose constraints in a follow-up study. METHODS: We performed a comprehensive search to identify the current papers on OAR dose constraints for normofractionated photon and particle therapy in PubMed, Ovid Medline, Cochrane Library, Embase and Web of Science. Moreover, the included articles' reference lists were cross-checked for potential studies that met the inclusion criteria. Consensus was reached among 20 radiation oncology experts in the field of neuro-oncology. RESULTS: For the OARs published in the neuro-oncology literature, we summarized the available literature and recommended dose constraints associated with certain levels of normal tissue complication probability (NTCP) according to the recent ICRU recommendations. For those OARs with lacking or insufficient NTCP data, a proposal for effective and efficient data collection is given. CONCLUSION: The use of the European Particle Therapy Network-consensus OAR dose constraints summarized in this article is recommended for the model-based approach comparing photon and proton beam irradiation as well as for prospective clinical trials including novel radiation techniques and/or modalities.

Clinic for Particle Therapy University Hospital Essen West German Cancer Center Partner Site Essen Germany

Danish Centre for Particle Therapy Aarhus Denmark

Department of Radiation Oncology Eberhard Carls Universität Tübingen Germany

Department of Radiation Oncology GROW School for Oncology and Developmental Biology Maastricht University Medical Centre The Netherlands

Department of Radiation Oncology Maastricht The Netherlands

Department of Radiation Oncology University Medical Center Groningen University of Groningen The Netherlands

Department of Radiotherapy and Radiation Oncology Faculty of Medicine and University Hospital Carl Gustav Carus Technische Universität Dresden Germany; Helmholtz Zentrum Dresden Rossendorf Institute of Radiooncology OncoRay Germany; OncoRay National Center for Radiation Research in Oncology Faculty of Medicine and University Hospital Carl Gustav Carus Technische Universität Dresden Helmholtz Zentrum Dresden Rossendorf Germany; German Cancer Consortium Partner Site Dresden Germany

Department of Radiotherapy Oncology Leuven Kanker Instituut UZ Gasthuisberg Belgium; Particle Therapy Interuniversitary Center Leuven Belgium

EBG MedAustron GmbH Wiener Neustadt Austria

Haaglanden Medisch Centrum Department of Radiotherapy Leidschendam The Netherlands

Holland Proton Therapy Centre Delft The Netherlands; Erasmus Medical Centre Rotterdam The Netherlands

Institut Curie Radiation Oncology Department Paris and Proton Center Orsay France

Institut Curie Radiation Oncology Department Paris and Proton Center Orsay France; Institute Curie Centre de Protonthérapie d'Orsay France

Leiden University Medical Centre Department of Radiotherapy The Netherlands; Holland Proton Therapy Centre Delft The Netherlands

Paul Scherrer Institut Med Center for Proton Therapy Switzerland

Proton Therapy Center Czech Prague Czech Republic

Service de Radiothérapie Oncologique Cliniques universitaires St Luc Brussels Belgium

The Skandion Clinic Uppsala Sweden; Danish Centre for Particle Therapy Aarhus Denmark

The University of Manchester Manchester Academic Health Science Centre The Christie NHS Foundation Trust United Kingdom; The Children's Brain Tumour Research Network University of Manchester Royal Manchester Children's Hospital United Kingdom

University of Cambridge Department of Oncology Cambridge Biomedical Campus Addenbrooke's Hospital United Kingdom

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