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• <=2 institutions agreed on high dose constraints for SpinalCord, Brainstem, or Bone_Mandible; D0.03cc[Gy] is recommended (versus Max[Gy] or D0.1cc[Gy]), to ensure interoperability. • Consider reducing constraint values for DVH metrics where real-world values are below literature set limits (e.g. esophagus LAMBDA consortium Mean 21Gy Median [15 Q1,28 Q3] significantly lower than QUANTEC Mean <34 Gy p=0.006 [0.003, 0.17])
               
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