Toward Patient-Specific, Biologically Optimized Radiation Therapy Plans for the Treatment of Glioblastoma

David Corwin, Clay Holdsworth, Russell C Rockne, Andrew D Trister, Maciej M Mrugala, Jason K Rockhill, Robert D Stewart, Mark Phillips and Kristin R Swanson

PLOS ONE, 2013, vol. 8, issue 11, 1-9

Abstract: Purpose: To demonstrate a method of generating patient-specific, biologically-guided radiotherapy dose plans and compare them to the standard-of-care protocol. Methods and Materials: We integrated a patient-specific biomathematical model of glioma proliferation, invasion and radiotherapy with a multiobjective evolutionary algorithm for intensity-modulated radiation therapy optimization to construct individualized, biologically-guided plans for 11 glioblastoma patients. Patient-individualized, spherically-symmetric simulations of the standard-of-care and optimized plans were compared in terms of several biological metrics. Results: The integrated model generated spatially non-uniform doses that, when compared to the standard-of-care protocol, resulted in a 67% to 93% decrease in equivalent uniform dose to normal tissue, while the therapeutic ratio, the ratio of tumor equivalent uniform dose to that of normal tissue, increased between 50% to 265%. Applying a novel metric of treatment response (Days Gained) to the patient-individualized simulation results predicted that the optimized plans would have a significant impact on delaying tumor progression, with increases from 21% to 105% for 9 of 11 patients. Conclusions: Patient-individualized simulations using the combination of a biomathematical model with an optimization algorithm for radiation therapy generated biologically-guided doses that decreased normal tissue EUD and increased therapeutic ratio with the potential to improve survival outcomes for treatment of glioblastoma.

Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0079115

DOI: 10.1371/journal.pone.0079115

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