title: Introduction and Clinical Overview of the DVH Risk Map.
abstract: Radiation oncologists need reliable estimates of risk for various fractionation schemes for all critical anatomical structures throughout the body, in a clinically convenient format. Reliable estimation theory can become fairly complex, however, and estimates of risk continue to evolve as the literature matures. To navigate through this efficiently, a dose-volume histogram (DVH) Risk Map was created, which provides a comparison of radiation tolerance limits as a function of dose, fractionation, volume, and risk level. The graphical portion of the DVH Risk Map helps clinicians to easily visualize the trends, whereas the tabular portion provides quantitative precision for clinical implementation. The DVH Risk Map for rib tolerance from stereotactic ablative body radiotherapy (SABR) and stereotactic body radiation therapy (SBRT) is used as an example in this overview; the 5% and 50% risk levels for 1-5 fractions for 5 different volumes are given. Other articles throughout this issue of Seminars in Radiation Oncology present analysis of new clinical datasets including the DVH Risk Maps for other anatomical structures throughout the body.
authors.affiliation: Department of Radiation Oncology, MD Anderson at Cooper University Hospital, Camden, NJ.
authors.forename: Sucha O
authors.initials: SO
authors.lastname: Asbell
authors.affiliation: Holy Redeemer Hospital, Bott Cancer Center, Meadowbrook, PA. Electronic address: JimmGrimmJr@yahoo.com.
authors.forename: Jimm
authors.initials: J
authors.lastname: Grimm
authors.affiliation: Department of Radiation Oncology, MD Anderson at Cooper University Hospital, Camden, NJ.
authors.forename: Jinyu
authors.initials: J
authors.lastname: Xue
authors.affiliation: Packard Lab, Lehigh University, Bethlehem, PA.
authors.forename: Meng-Sang
authors.initials: MS
authors.lastname: Chew
authors.affiliation: Department of Radiation Oncology, MD Anderson at Cooper University Hospital, Camden, NJ.
authors.forename: Tamara A
authors.initials: TA
authors.lastname: LaCouture
mesh_terms: D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D011832:Radiation Injuries / Q000517:prevention & control*; D011836:Radiation Tolerance; D016634:Radiosurgery / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012306:Risk