A risk-based modeling approach for radiation therapy treatment planning under tumor shrinkage uncertainty

Gino J. Lim, Laleh Kardar, Saba Ebrahimi and Wenhua Cao

European Journal of Operational Research, 2020, vol. 280, issue 1, 266-278

Abstract: Robust optimization approaches have been widely used to address uncertainties in radiation therapy treatment planning problems. Because of the unknown probability distribution of uncertainties, robust bounds may not be correctly chosen, and a risk of undesirable effects from worst-case realizations may exist. In this study, we developed a risk-based robust approach, embedded within the conditional value-at-risk representation of the dose-volume constraint, to deal with tumor shrinkage uncertainty during radiation therapy. The objective of our proposed model is to reduce dose variability in the worst-case scenarios as well as the total delivered dose to healthy tissues and target dose deviations from the prescribed dose, especially, in underdosed scenarios. We also took advantage of adaptive radiation therapy in our treatment planning approach. This fractionation technique considers the response of the tumor to treatment up to a particular point in time and reoptimizes the treatment plan using an estimate of tumor shrinkage. The benefits of our model were tested in a clinical lung cancer case. Four plans were generated and compared: static, nominal-adaptive, robust-adaptive, and conventional robust (worst-case) optimization. Our results showed that the robust-adaptive model, which is a risk-based model, achieved less dose variability and more control on the worst-case scenarios while delivering the prescribed dose to the tumor target and sparing organs at risk. This model also outperformed other models in terms of tumor dose homogeneity and plan robustness.

Keywords: OR in medicine; Radiation therapy planning; Tumor shrinkage; Risk management; CVaR (search for similar items in EconPapers)
Date: 2020
References: Add references at CitEc
Citations: View citations in EconPapers (4)

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S037722171930534X
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:ejores:v:280:y:2020:i:1:p:266-278

DOI: 10.1016/j.ejor.2019.06.041

Access Statistics for this article

European Journal of Operational Research is currently edited by Roman Slowinski, Jesus Artalejo, Jean-Charles. Billaut, Robert Dyson and Lorenzo Peccati

More articles in European Journal of Operational Research from Elsevier
Bibliographic data for series maintained by Catherine Liu ().