Optimization of Radiation Therapy Fractionation Schedules in the Presence of Tumor Repopulation
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Tsitsiklis_Optimization of radiation.pdf
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Author(s)
Bortfeld, Thomas
Ramakrishnan, Jagdish
Unkelbach, Jan
Tsitsiklis, John N
Date Issued
December 2015
Journal
INFORMS Journal on Computing
Publisher
Institute for Operations Research and the Management Sciences (INFORMS)
Citation
Bortfeld, Thomas et al. “Optimization of Radiation Therapy Fractionation Schedules in the Presence of Tumor Repopulation.” INFORMS Journal on Computing 27, 4 (November 2015): 788–803 © 2015 Institute for Operations Research and the Management Sciences (INFORMS)
Version
Original manuscript
Abstract
We analyze the effect of tumor repopulation on optimal dose delivery in radiation therapy. We are primarily motivated by accelerated tumor repopulation toward the end of radiation treatment, which is believed to play a role in treatment failure for some tumor sites. A dynamic programming framework is developed to determine an optimal fractionation scheme based on a model of cell kill from radiation and tumor growth in between treatment days. We find that faster tumor growth suggests shorter overall treatment duration. In addition, the presence of accelerated repopulation suggests larger dose fractions later in the treatment to compensate for the increased tumor proliferation. We prove that the optimal dose fractions are increasing over time. Numerical simulations indicate a potential for improvement in treatment effectiveness.
MIT Department
Massachusetts Institute of Technology. Laboratory for Information and Decision Systems
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Creative Commons Attribution-Noncommercial-Share Alike
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DOI of Published Version
https://doi.org/10.1287/ijoc.2015.0659
