Re-optimization in adaptive radiotherapy

In routine clinical practice, radiotherapy treatment planning is performed based on the patient CT images obtained during the patient setup procedure. However, the actual delivered dose to the patient might be different from the planned dose because of various reasons such as patient motion. Under s...

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Bibliographic Details
Published in:Physics in medicine & biology 2002-09, Vol.47 (17), p.3181-3195
Main Authors: Wu, Chuan, Jeraj, Robert, Olivera, Gustavo H, Mackie, Thomas R
Format: Article
Language:English
Subjects:
Algorithms
Biological and medical sciences
Computerized tomography
Dose Fractionation, Radiation
Feedback
Humans
Immobilization
Medical sciences
Motion
Nasopharyngeal Neoplasms - diagnostic imaging
Nasopharyngeal Neoplasms - radiotherapy
Optimization
Patient monitoring
Quality Control
Radiometry - methods
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted - methods
Radiotherapy, Conformal - methods
Tomography, X-Ray Computed - methods
Tumors
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Summary:In routine clinical practice, radiotherapy treatment planning is performed based on the patient CT images obtained during the patient setup procedure. However, the actual delivered dose to the patient might be different from the planned dose because of various reasons such as patient motion. Under such situations, it is desirable to modify the original treatment plan in order to partially remedy the dose delivery errors in the subsequent dose delivery process. Such modification can be implemented by modifying the original treatment plan using re-optimization. In this work, issues such as the re-optimization dose prescription, optimization constraints in re-optimization, re-optimization in multiple fractionation schemes and re-optimization procedure with generalized dose-based objective functions were investigated and corresponding mathematical schemes proposed. The derived results were applied to a clinical case study in which it was shown that the proposed re-optimization method is able to remedy the cold spots in tumour while delivering low dose to normal structures. Thus the potential effectiveness of the method was demonstrated.
ISSN:0031-9155
1361-6560
DOI:10.1088/0031-9155/47/17/309