A role for biological optimization within the current treatment planning paradigm

Medical Physics
S K Das

Abstract

Biological optimization using complication probability models in intensity modulated radiotherapy (IMRT) planning has tremendous potential for reducing radiation-induced toxicity. Nevertheless, biological optimization is almost never clinically utilized, probably because of clinician confidence in, and familiarity with, physical dose-volume constraints. The method proposed here incorporates biological optimization after dose-volume constrained optimization so as to improve the dose distribution without detrimentally affecting the important reductions achieved by dose-volume optimization (DVO). Following DVO, the clinician/planner first identifies "fixed points" on the target and organ-at-risk (OAR) dose-volume histograms. These points represent important DVO plan qualities that are not to be violated within a specified tolerance. Biological optimization then maximally reduces a biological metric (illustrated with equivalent uniform dose (EUD) in this work) while keeping the fixed dose-volume points within tolerance limits, as follows. Incremental fluence adjustments are computed and applied to incrementally reduce the OAR EUDs while approximately maintaining the fixed points. This process of incremental fluence adjustment is it...Continue Reading

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Citations

Dec 20, 2011·Seminars in Radiation Oncology·Kevin L MooreSasa Mutic
May 3, 2011·Zeitschrift für medizinische Physik·Thomas DirscherlLudwig Bogner
Oct 12, 2010·International Journal of Radiation Oncology, Biology, Physics·Cathy FlemingJohn Armstrong
Jul 22, 2010·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Philippe LambinDirk De Ruysscher
Nov 2, 2015·Medical Physics·Sarah C BrüningkJan J Wilkens
May 17, 2011·International Journal of Radiation Oncology, Biology, Physics·Ivaylo B MihaylovEduardo G Moros
Dec 6, 2014·Frontiers in Oncology·Ivaylo B Mihaylov, Eduardo G Moros
Aug 8, 2014·Frontiers in Oncology·Ivaylo B Mihaylov
Sep 12, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Roel G J KierkelsJohannes A Langendijk
Aug 28, 2010·Physics in Medicine and Biology·Dionne M AlemanJames F Dempsey
Nov 30, 2019·Technology in Cancer Research & Treatment·Caiping GuoJinrong Xu
Jan 4, 2017·Computational and Mathematical Methods in Medicine·Marco D'AndreaLidia Strigari

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