Optimization of radiation therapy fractionation schedules in the presence of tumor repopulation

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Publication:2802256

DOI10.1287/IJOC.2015.0659zbMATH Open1338.90440arXiv1312.1332OpenAlexW1612099526MaRDI QIDQ2802256FDOQ2802256

Jan Unkelbach, John N. Tsitsiklis, Jagdish Ramakrishnan, Thomas Bortfeld

Publication date: 25 April 2016

Published in: INFORMS Journal on Computing (Search for Journal in Brave)

Abstract: We analyze the effect of tumor repopulation on optimal dose delivery in radiation therapy. We are primarily motivated by accelerated tumor repopulation towards 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 due to 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 potential for improvement in treatment effectiveness.


Full work available at URL: https://arxiv.org/abs/1312.1332





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