Optimizing the Delivery of Radiation Therapy to Cancer Patients

In the field of radiation therapy, much of the research is aimed at developing new and innovative techniques for treating cancer patients with radiation. In recent years, new treatment machines have been developed that provide a much greater degree of computer control than was available with the machines of previous generations. One innovation has been the development of an approach called "tomotherapy.'' Tomotherapy can be defined as computer-controlled rotational radiotherapy delivered using an intensity-modulated fan beam of radiation. The successful implementation of the new delivery techniques requires the development of a suitable approach for optimizing each patient's treatment plan. One of the challenges is to quantify optimality in radiation therapy. We have tested a variety of objective functions and constraints in pursuit of a formulation that performs well for a wide variety of disease sites. An additional challenge stems from the sizable amount of data and the large number of variables that are involved in each optimization. This paper presents several approaches to optimizing treatment plans in radiation therapy, and the advantages and disadvantages of a number of formulations are explored.