TITLE:
IMRT Optimization with Both Fractionation and Cumulative Constraints
AUTHORS:
Delal Dink, Mark Langer, Seza Orcun, Joseph Pekny, Ronald Rardin, Gintaras Reklaitis, Behlul Saka
KEYWORDS:
IMRT, Mixed-Integer Linear Programming, Optimization, Cumulative Dose Constraints, Fractionation, Two-Phase Planning, Uniform Fractionation
JOURNAL NAME:
American Journal of Operations Research,
Vol.1 No.3,
September
30,
2011
ABSTRACT: Radiation therapy plans are optimized as a single treatment plan, but delivered over 30 - 50 treatment sessions (known as fractions). This paper proposes a new mixed-integer linear programming model to simultaneously incorporate fractionation and cumulative constraints in Intensity Modulated Radiation Therapy (IMRT) planning optimization used in cancer treatment. The method is compared against a standard practice of posing only cumulative limits in the optimization. In a prostate case, incorporating both forms of limits into planning converted an undeliverable plan obtained by considering only the cumulative limits into a deliverable one within 3% of the value obtained by ignoring the fraction size limits. A two-phase boosting strategy is studied as well, where the first phase aims to radiate primary and secondary targets simultaneously, and the second phase aims to escalate the tumor dose. Using of the simultaneous strategy on both phases, the dose difference between the primary and secondary targets was enhanced, with better sparing of the rectum and bladder.